371: Maternal outcomes of pregnancies complicated by fetal life-limiting or lethal conditions

Abstract

(NY). Subjects were screened during pregnancy or postpartum. Those who screened positive ('Red Flags' , >3-4 moderate risk factors, abnormal physical examination, persistent symptoms) underwent further testing. The primary outcome was screen positive rate. Secondary outcomes were true positive rate and the strength of each moderate factor in predicting CVD. Univariate logistic regression was used to analyze data. RESULTS: 846 women were screened. The overall screen positive rate was 8% (5% in CA vs 19% in NY). The sites differed in ethnicity, i.e. African American women (2.7% in CA vs 35% in NY, p< 0.01) and substance use (2.7% vs 5.6%, p< 0.04). The true positive rate was 1.5% at both sites, however several of the screen positive patients in NY did not complete follow up studies. CVD was confirmed in 30% with positive screens with complete follow up. Combinations of moderate factors were the main driver of screen positive rates in both populations. Table 1 illustrates predictive potential of the moderate risk factors. CONCLUSION: CVD is the leading cause of maternal mortality and 25% of these cases are preventable, highlighting the need for an effective screening tool. We report CVD screen positive and true positive rates at two academic tertiary care centers serving diverse populations. We identify the most predictive moderate factors that may help simplify the CVD toolkit algorithm. Our study is limited by lack of follow up studies in screen positive patients, however suggests a substantial rate of true CVD in screen positive patients. This is an initial attempt to test the CVD algorithm. Data may be used to design a larger investigation to validate the algorithm.