Abstract 11854: Nationwide In-hospital Outcomes of Pregnancy in Women With Single Ventricle Congenital Heart Disease

Introduction: Most patients with single ventricle (SV) congenital heart disease (CHD) are expected to survive to adulthood. Women with SV are often counseled against pregnancy; however, data on pregnancies in these women are lacking. We sought to evaluate in-hospital outcomes of pregnancy in women with SV. Methods: We used nationally representative data from 1998 to 2012 Nationwide Inpatient Sample database to identify patients ≥ 18 years of age admitted to the hospital with International Classification of Diseases-9th Revision codes for an intrauterine pregnancy and a diagnosis of either hypoplastic left heart syndrome, tricuspid atresia or common ventricle. A matched comparison group without a diagnosis of CHD or pulmonary hypertension was identified from the database. National estimates of hospitalizations were calculated. Length of stay (LOS), total hospital charges, and cardiovascular complications were analyzed and compared between groups. Charge data were adjusted to 2012 dollars. Results: There were 310 admissions of pregnant women with SV (63% with deliveries) and 1547 admissions in the control group (91% with deliveries). There was no change in the annual number of SV pregnancies during the study period. Vaginal delivery was more common in SV (74% vs 72%, p<0.001). LOS (4.6 [0.98] days vs 2.5 [0.07], p<0.001) and charges ($38,627 [11,918] vs $13,880 [631], p<0.0001) were higher in SV. SV deliveries occurred more commonly in teaching hospitals (78% vs 51%, p<0.001). Complications occurred in nearly all SV admissions and were more common in SV compared to controls. (Table) There were no deaths in either group. Conclusions: Pregnancies in women with SV are associated with increased hospital resource utilization and cardiovascular complications, though in-hospital pregnancy related death is rare. Vaginal delivery is common in these patients. These data suggest that pregnancy and vaginal delivery are well tolerated in women with SV.