155: Hospital admissions 2 to 9 months after delivery among women with adult congenital heart disease

Women with adult congenital heart disease (ACHD) are at increased risk of postpartum readmissions. However, longer term risk for hospitalizations is not well characterized. This analysis sought to characterize risk for hospital admissions 2 to 9 months after delivery hospitalization for women with ACHD. Delivery hospitalizations for women with ACHD (categorized into complex, non-complex, and unspecified ACHD) were abstracted from the 2010-2014 Nationwide Readmissions Database with follow up through 9 months after delivery hospitalization discharge. Multivariable log linear regression models were fit for the outcome of readmission from 2 to 9 months following delivery adjusting for type of ACHD, patient, obstetric, and other underlying cardiac factors. We identified 3,507 deliver hospitalizations occurring between January-March of 2010-2014 with an all-cause hospitalization rate of 7.9% in the first 9 months after delivery. 44% of readmissions occurred within 60 days after delivery hospitalization discharge with the majority (56%) occurring 2 to 9 months after discharge (Figure 1). The median time to readmission was 72 days. Among readmissions from 2 to 9 months after discharge, patients with complex ACHD were at 64% higher risk of readmission (RR 1.64, 95% CI 1.01, 2.67) while factors like congestive heart failure, arrhythmias, and obstetrical factors were not associated with elevated risk (Table 1). The majority of ACHD hospitalizations in the 9 months after delivery occur after 2 months postpartum. These findings support the importance of health care coverage and continuity for this high-risk population.View Large Image Figure ViewerDownload Hi-res image Download (PPT)