Maternal and Fetal Outcomes Associated With Infective Endocarditis in Pregnancy.

dc.contributor.author

Dagher, Michael M

dc.contributor.author

Eichenberger, Emily M

dc.contributor.author

Addae-Konadu, Kateena L

dc.contributor.author

Dotters-Katz, Sarah K

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Kohler, Celia L

dc.contributor.author

Fowler, Vance G

dc.contributor.author

Federspiel, Jerome J

dc.date.accessioned

2022-02-01T19:58:05Z

dc.date.available

2022-02-01T19:58:05Z

dc.date.issued

2021-11

dc.date.updated

2022-02-01T19:58:04Z

dc.description.abstract

Background

Infective endocarditis (IE) is a rare but serious infection that complicates pregnancy. Little is known about IE management and outcomes in this population.

Methods

The National Readmissions Database was used to obtain data between October 2015 and October 2018. Billing codes identified admissions for IE in female patients of reproductive age. Demographic characteristics, comorbidities, and outcomes were compared between patients with maternity-associated and nonmaternity-associated IE and obstetric patients who delivered with and without IE. Weighted regressions were used to examine outcomes in adjusted models.

Results

We identified 12 602 reproductive-aged female patients with a diagnosis of IE, of which 382 (weighted national estimate, 748) were maternity-associated. Of these cases, 117 (weighted national estimate, 217) occurred during a delivery admission. Compared with patients with nonmaternity-associated IE, maternity-associated infection was associated with younger age (mean, 29.0 vs 36.6 years; P < .001), Medicaid coverage (72.5% vs 47.2%; P < .001), and drug use (76.2% vs 59.8%; P < .001). Mortality was comparable (8.1% vs 10.6%; adjusted rate ratio [aRR], 1.03; 95% confidence interval [CI]: .71-1.48). Compared with patients who delivered without IE, IE complicating delivery was associated with worse maternal and fetal outcomes, including maternal mortality (17.2% vs <0.01%; aRR, 323.32; 95% CI: 127.74-818.37) and preterm birth (55.7% vs 10.1%; aRR, 3.61; 95% CI, 2.58-5.08).

Conclusions

Maternity-associated IE does not appear to confer additional risk for adverse outcome over nonmaternity-associated infection. Patients who deliver with IE have worse maternal and fetal outcomes than those whose deliveries are not complicated by IE.
dc.identifier

6296024

dc.identifier.issn

1058-4838

dc.identifier.issn

1537-6591

dc.identifier.uri

https://hdl.handle.net/10161/24325

dc.language

eng

dc.publisher

Oxford University Press (OUP)

dc.relation.ispartof

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

dc.relation.isversionof

10.1093/cid/ciab533

dc.subject

Humans

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Endocarditis, Bacterial

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Premature Birth

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Endocarditis

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Hospitalization

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Maternal Mortality

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Risk Factors

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Retrospective Studies

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Pregnancy

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Adult

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Infant, Newborn

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Female

dc.title

Maternal and Fetal Outcomes Associated With Infective Endocarditis in Pregnancy.

dc.type

Journal article

duke.contributor.orcid

Dagher, Michael M|0000-0002-4305-9294

duke.contributor.orcid

Eichenberger, Emily M|0000-0002-2469-0638

duke.contributor.orcid

Dotters-Katz, Sarah K|0000-0002-9951-8330

duke.contributor.orcid

Fowler, Vance G|0000-0002-8048-0897

duke.contributor.orcid

Federspiel, Jerome J|0000-0003-0321-6280

pubs.begin-page

1571

pubs.end-page

1579

pubs.issue

9

pubs.organisational-group

Duke

pubs.organisational-group

School of Medicine

pubs.organisational-group

Staff

pubs.organisational-group

Basic Science Departments

pubs.organisational-group

Clinical Science Departments

pubs.organisational-group

Institutes and Centers

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Molecular Genetics and Microbiology

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Medicine

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Obstetrics and Gynecology

pubs.organisational-group

Medicine, Infectious Diseases

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Duke Clinical Research Institute

pubs.publication-status

Published

pubs.volume

73

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