Acute cardiovascular events during the peripartum period: pregnancy and delivery outcomes in patients with autoimmune rheumatic diseases—an analysis of the National Inpatient Sample

Background: Pregnant patients with concomitant autoimmune rheumatic disease (ARDs) are at higher risk of major cardiovascular diseases. However, acute complications during delivery are less understood. This study analyzed cardiovascular complications in ARDs patients during delivery. Methods: The National Inpatient Sample (2016–2021) was analyzed using ICD-10 codes to identify ARDs patients hospitalized for delivery. The primary cardiovascular and inpatient outcomes were compared between patients with and without ARDs. Results: Systemic lupus erythematosus (SLE) remained an independent risk factor for preeclampsia (odds ratio [OR] 1.5), arrhythmia (OR 3.17), and venous thrombosis (OR 8.4). Vasculitides increased the risk for preeclampsia (OR 4.7), stroke (OR 513.3), heart failure (OR 24.17), and peripartum cardiomyopathy (OR 66.7). Rheumatoid arthritis was a risk factor for preeclampsia only (OR 1.5). Mortality was high in SLE (0.17% vs 0.0001%) and vasculitides (1.54% vs 0.0001%). Longer hospital stays occurred for patients with SLE (3.7 vs 2.5 days) and vasculitides (4.7 vs 2.5 days). Hospitalization costs were higher for those with rheumatoid arthritis ($26,182), SLE ($34,880), and vasculitides ($74,839) versus those without ($23,500). Conclusion: This study found an increased risk of cardiovascular complications in ARDs patients during hospitalization for delivery. They also had longer hospital stays and higher hospitalization costs.