Abstract 14: Disparities in Cardiovascular Disease Outcomes Among Pregnant Females

Introduction: The incidence of cardiovascular (CV) disease among pregnant women is rising in the United States (US). Data on racial disparities for the major CV events during pregnancy are limited.

Methods: Pregnant women hospitalized from January 2007 to September 2015 were identified in the Nationwide Inpatient Sample. Outcomes of interest were mortality, myocardial infarction (MI), stroke, and pulmonary embolism (PE). Multivariate regression analysis was used for Odds Ratio (OR) and 95% Confidence Interval (CI).

Results: Among 37,524,315 pregnant women, 17,159,400 (45.7%) were White, 4,921,574 (13.1%) were African American, and 7,111,216 (19.0%) were Hispanic. Following 2010, trends of mortality and stroke declinedsignificantly in African Americans, however, were stable in Whites (Figure). In-hospital mortality was 13.52 per 100,000 hospitalizations. The incidence of in-hospital mortality was highest among AfricanAmericans followed by White, then Hispanic patients; 29.63, 10.61, and 9.73 per 100,000 hospitalizations, respectively. The majority of African Americans (61.9%) were insured by Medicaid while the majority of White patients had private insurance (61.9%). Most of African American patients were below-median income (70.54%) while nearly half of the White patients were above the median income (47%). Compared to Whites, African Americans had the highest mortality with OR of 2.79, 95% CI (2.61-2.99), myocardial infarction with OR of 2.178, 95% CI (2.01-2.36), stroke with OR of 2.04, 95% CI (1.96-2.13), and pulmonary embolism with OR of 1.95, 95% CI (1.82-2.08).

Conclusions: Significant racial disparities exist in the major CV events among pregnant women. Further efforts are needed to minimize these differences.