Assessing Pregnancy, Gestational Complications, and Co-morbidities in Women With Congenital Heart Defects (Data from ICD-9-CM Codes in 3 US Surveillance Sites)

Improved treatment of congenital heart defects (CHDs) has resulted in women with CHDs living to childbearing age. However, no US population-based systems exist to estimate pregnancy frequency or complications among women with CHDs. Cases were identified in multiple data sources from 3 surveillance s...

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Bibliographic Details
Published in:	The American journal of cardiology 2020-03, Vol.125 (5), p.812-819
Main Authors:	Raskind-Hood, Cheryl, Saraf, Anita, Riehle-Colarusso, Tiffany, Glidewell, Jill, Gurvitz, Michelle, Dunn, Julie E., Lui, George K., Van Zutphen, Alissa, McGarry, Claire, Hogue, Carol J., Hoffman, Trenton, Rodriguez III, Fred H., Book, Wendy M.
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Age Anemia - epidemiology Arrhythmias, Cardiac - epidemiology Cardiovascular disease Catchment Area, Health Catchment areas Child Codes Comorbidity Complications Congenital diseases Coronary Artery Disease - epidemiology Coronary vessels Defects Demographics Demography Diabetes Diabetes, Gestational - epidemiology Essential Hypertension - epidemiology Female Georgia - epidemiology Gynecology Health care policy Health insurance Heart Defects, Congenital - epidemiology Humans Hyperemesis Gravidarum - epidemiology Hyperlipidemias - epidemiology Hypertension Hypertension, Pregnancy-Induced - epidemiology Infectious diseases Information Storage and Retrieval Insurance Insurance Coverage - statistics & numerical data International Classification of Diseases Massachusetts - epidemiology Medicaid Medically Uninsured Medicare Middle Aged Morbidity New York - epidemiology Obesity, Maternal - epidemiology Obstetric Labor, Premature - epidemiology Population Pregnancy Pregnancy complications Pregnancy Complications - epidemiology Pregnancy Complications, Cardiovascular - epidemiology Pregnancy Complications, Hematologic - epidemiology Pregnancy Complications, Infectious - epidemiology Pregnancy Rate Public health Reproductive health Stroke - epidemiology Surveillance Thrombosis - epidemiology Ultrasonic imaging United States - epidemiology Womens health Young Adult
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Summary:	Improved treatment of congenital heart defects (CHDs) has resulted in women with CHDs living to childbearing age. However, no US population-based systems exist to estimate pregnancy frequency or complications among women with CHDs. Cases were identified in multiple data sources from 3 surveillance sites: Emory University (EU) whose catchment area included 5 metropolitan Atlanta counties; Massachusetts Department of Public Health (MA) whose catchment area was statewide; and New York State Department of Health (NY) whose catchment area included 11 counties. Cases were categorized into one of 5 mutually exclusive CHD severity groups collapsed to severe versus not severe; specific ICD-9-CM codes were used to capture pregnancy, gestational complications, and nongestational co-morbidities in women, age 11 to 50 years, with a CHD-related ICD-9-CM code. Pregnancy, CHD severity, demographics, gestational complications, co-morbidities, and insurance status were evaluated. ICD-9-CM codes identified 26,655 women with CHDs, of whom 5,672 (21.3%, range: 12.8% in NY to 22.5% in MA) had codes indicating a pregnancy. Over 3 years, age-adjusted proportion pregnancy rates among women with severe CHDs ranged from 10.0% to 24.6%, and 14.2% to 21.7% for women with nonsevere CHDs. Pregnant women with CHDs of any severity, compared with nonpregnant women with CHDs, reported more noncardiovascular co-morbidities. Insurance type varied by site and pregnancy status. These US population-based, multisite estimates of pregnancy among women with CHD indicate a substantial number of women with CHDs may be experiencing pregnancy and complications. In conclusion, given the growing adult population with CHDs, reproductive health of women with CHD is an important public health issue.
ISSN:	0002-9149 1879-1913