Older, Black, and low-income pregnant patients more likely to suffer cardiac arrest when hospitalized for delivery

Abstract: https://www.acpjournals.org/doi/10.7326/M22-2750 

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A study of pregnant women hospitalized during delivery found that cardiac arrest occurred in about 1 in 9,000 deliveries, a rate that is higher than previously reported estimates. Cardiac arrest was more common among patients who were older, were non-Hispanic Black, had Medicare or Medicaid, or had underlying medical conditions. The findings are published in Annals of Internal Medicine.  

Cardiac arrest is an uncommon but serious maternal complication that is an indicator of severe maternal morbidity and mortality. Estimates of severe maternal complications occurring during delivery hospitalization can provide information for evidence-based strategies to reduce pregnancy-related death.

Researchers from the Centers for Disease Control and Prevention (CDC) studied data from the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) from 2017 to 2019 to investigate rate of cardiac arrest during delivery hospitalization. The authors also looked at the patient characteristics associated with cardiac arrest and survival rates. Among the 10,921,784 U.S. delivery hospitalizations included in the data, the cardiac arrest rate was 13.4 per 100,000 and about a third of those patients survived to hospital discharge. Survival was lowest with co-occurring disseminated intravascular coagulation (DIC). The researchers could not determine cause of cardiac arrest or identify whether co-occurring severe maternal complications came before or after cardiac arrest. Acute respiratory distress syndrome was the most common co-occurring diagnosis, and cardiac arrest rates were high among hospitalizations where a diagnosis of amniotic fluid embolism was noted. According to the authors, implementing clinical guidelines, ensuring that pregnant people receive risk-appropriate care, and addressing potential knowledge deficits in maternal cardiac arrest and cardiopulmonary resuscitation technique for pregnant people may improve maternal outcomes.

 

Media contacts: For an embargoed PDF, please contact Angela Collom at [email protected]. To speak with the corresponding author, Romeo Galang, MD, please email [email protected].