Abstract 4143073: Comparative Clinical Outcomes Following Transcatheter Mitral Valve repair in Patients with a History of Adverse Pregnancy Outcomes Versus Those Without: A National Inpatient Sample Analysis

Background: Adverse pregnancy outcomes (APO) pose long-term cardiovascular risks. Considering the potential impact of APO on maternal health, this study aims to investigate the characteristics and clinical outcomes of women who have experienced APO and subsequently undergo transcatheter mitral valve repair (TMVr). Methods: This is a retrospective cohort study that analyzed data from 15,220 women who underwent transcatheter mitral valve repair (TMVr) and it was divided into two groups: history of adverse pregnancy outcome (APO, n=3240) and without a history of APO (No APO, n=11,980). Comparative analyses between the APO and No APO groups were performed using t-tests for continuous variables and chi-square tests for categorical variables. Multivariate logistic regression models were employed to adjust for potential confounders and identify independent predictors of in-hospital mortality and other adverse outcomes. Odds ratios (OR) and 95% confidence intervals (CI) were calculated for each variable. Results: Patients with a history of adverse pregnancy outcomes (APOs) were younger (mean age 73.3 vs. 79.0 years, p<0.001) and more frequently identified as Black/African American (20.9% vs. 8.0%, p<0.001). They had a higher mean Charlson Comorbidity Index (3.2 vs. 2.8, p<0.001). After adjustment, these patients were more likely to require mechanical ventilation (OR 0.76, 95% CI 0.61-0.94, p=0.0112) and vasopressors (OR 1.37, 95% CI 1.05-1.79, p=0.0205), experience heart block (OR 2.29, 95% CI 2.00-2.63, p<0.001), and develop acute kidney injury (OR 1.26, 95% CI 1.12-1.42, p=0.0001). However, the adjusted odds of in-hospital mortality did not differ significantly between the groups (OR 0.99, 95% CI 0.73-1.32, p=0.9355). Conclusions: Women with a history of adverse pregnancy outcomes (APOs) undergoing TMVr face higher risks of complications, such as heart block and acute kidney injury, highlighting the importance of incorporating pregnancy history into cardiovascular risk assessment and management for these patients.