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///2016 Abstract Details
2016 Abstract Details2019-07-15T10:10:51-05:00

Epidemiology of maternal cardiac arrest in Canada: A nationwide study

Abstract Number: BP-04
Abstract Type: Original Research

Leyla Baghirzada MD, FRCPC, MPH1 ; Shiliang Liu MB, PhD2; Juan Andrés León MD, MSc3; Mrinalini Balki MD4

Introduction:Cardiac arrest during pregnancy is a rare event with an estimated incidence of 1:30,000 to 1:50,000 deliveries.[1] Such events can be catastrophic,leading to a significant potential for major maternal and neonatal morbidity and mortality.[2]

The objective of this study was to generate information about maternal cardiac arrest in Canada by examining the frequency, temporal incidence, associated conditions, maternal survival and fatality rates.

Methods: This retrospective cohort study was based on the hospitalization database for childbirth in Canada (except Quebec)from 2002/03 to 2013/14. The study population included women with gestational age 20 weeks and higher having cardiac arrest during hospitalization for childbirth. Cardiac arrest was defined based on ICD-10-CA diagnostic (I46.0, I46.1, I46.9, I49.00, I49.01) and intervention codes (1.HZ.30.^^, 1.HZ.09.JA-FS, 1.HZ.09.LA-FS, 1.HZ.09.LA-CJ). Data were summarized using descriptive statistics. Multivariable logistic regression analysis was used to identify medical and obstetrical conditions independently associated with maternal cardiac arrest.

Results: There were 261 cases of maternal cardiac arrest among 3,282,150 hospitalizations for delivery.185 women (70.9%, 95% CI 65.2% to 76.2%)survived to hospital discharge. The fatality rate was 28.8%. The frequency of cardiac arrest in 2002-2014 varied from 5 to 11 per 100,000 deliveries; there was no difference between the years (p=0.26). There was no variation in the incidence among Canadian provinces (p=0.42). Women who suffered cardiac arrest were more likely to be 35 yr and older (OR 2.34; 95% CI 1.69 to 3.26). Aortic aneurysm and dissection was the most common condition associated with maternal cardiac arrest, followed by obstetric embolism and heart failure. Table 1 lists statistically significant associations between maternal obstetric/ medical conditions, and cardiac arrest.

Discussion: This is the first Canadian population based cohort study on the epidemiology of maternal cardiac arrest. The event rate is 8:100,000 deliveries. Survival rate reported in this study is higher than previously reported, potentially owing to the differences in case identification between the studies.[2] This information could be used to develop prospective database of the cases and guide development of the system approach in dealing with this condition.

Reference:

1. Cantwell R et al. BJOG 2011; 118:1–203.

2. Dijkman A et al.BJOG 2010;117: 282–7.



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