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Background and Aims Contemporary data on the prevalence, trends, and outcomes of cardiovascular, diseases (CVD) in pregnant patients are limited. This study aimed to analyze the, prevalence, trends, and outcomes of CVD and their subtypes in hospitalized pregnant, patients in the United States (U.S.). Methods This retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients from January 1, 2010, to, December 31, 2019. Data analyses were conducted from January-February 2022., Pregnancy-associated hospitalizations were identified. Main outcomes were, prevalence and trend of CVD in pregnant patients. Results 39,212,104 hospitalized pregnant patients were identified: 4,409,924 with CVD (11.3%), and 34,802,180 without CVD (88.8%). The annual age adjusted CVD prevalence, increased from 9.2% in 2010 to 14.8% in 2019 (p < 0.001). Hypertensive disorder of, pregnancy (1069/10,000) was the most common, and aortic dissection (0.1/10,000), was the least common CVD. Trends of all CVD subtypes increased; however, the trend, of valvular heart disease decreased. Age adjusted in-hospital all-cause mortality was, 8.2/10,000 in CVD but its trend decreased from 8.1/10,000 in 2010 to 6.5/10,000 in, 2019 (p < 0.001). CVD was associated with 15.51 times higher odds of in-hospital allcause, mortality compared with non-CVD patients (odds ratio (OR): 15.51, 95% CI, 13.22-18.20, p < 0.001). CVD was associated with higher 6-week postpartum readmission (OR: 1.97, 95% CI: 1.95-1.99), myocardial infarction (OR: 3.04, 95% CI:, 2.57-3.59), and stroke (OR: 2.66, 95% CI: 2.41-2.94) (p < 0.001 for all). Conclusion There is an increasing age adjusted trend in overall CVD and its subtypes among, pregnant patients in the U.S. from 2010 to 2019. Pregnant patients with CVD had, higher odds of in-hospital mortality than those without CVD. However, in-hospital allcause, mortality among patients with and without CVD decreased over the past 10, years. CVD was associated with higher 6-week postpartum all-cause readmission, myocardial infarction, and stroke.

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Introduction: Contemporary data on the prevalence, trends, and outcomes of cardiovascular diseases (CVD) in pregnant patients are limited. Hypothesis: We aimed to analyze the prevalence, trends, and outcomes of CVD and their subtypes in hospitalized pregnant patients in the United States (U.S.). Methods: This retrospective population-based cohort study used the Nationwide Readmission Database to identify all hospitalized pregnant patients from January 1, 2010, to December 31, 2019. Pregnancy-associated hospitalizations were identified, and patients with missing information on the length of stay (LOS) and mortality were excluded. Main outcomes were prevalence and trend of CVD burden in pregnant patients. Results: 39,212,104 hospitalized pregnant patients were identified: 4,409,924 with CVD (11.25%) and 34,802,180 without CVD (88.75%). The annual CVD burden increased from 9.49 % in 2010 to 15.54 % in 2019 (p<0.001). Hypertensive disorder of pregnancy (1069/10,000) was the most common, and aortic dissection (0.1/10,000) was the least common CVD. Trends of all CVD subtypes increased; however, the trend of valvular heart disease decreased. In-hospital mortality was 8.2/10,00 in CVD but its trend decreased from 8.9/10,000 in 2010 to 7.4/10,000 in 2019 (p<0.001). CVD was associated with higher odds of mortality compared with non-CVD patients (odds ratio (OR): 32.7, 95% CI 28.8-37.1, p<0.001). CVD was associated with higher 6-week postpartum readmission (OR: 1.97, 95% CI: 1.95-1.99), myocardial infarction (OR: 3.04, 95% CI: 2.57-3.59), and stroke (OR: 2.66, 95% CI: 2.41-2.94) (p<0.001 for all). Conclusions: Overall CVD burden is high among pregnant patients with a significant uptrend of CVDs from 2010 to 2019 in the U.S. CVD burden was associated with higher in-hospital mortality, and 6-week postpartum all-cause readmission, myocardial infarction, and stroke. However, mortality among CVD patients decreased from 2010 to 2019 in the U.S.