Background Heart failure (HF) is a leading cause of maternal morbidity and mortality in the United States, but prevalence, correlates, and outcomes of HF-related hospitalization during antepartum, delivery, and postpartum periods remain unknown. The objective was to examine HF prevalence, correlates, and outcomes among pregnancy-related hospitalizations among women 13 to 49 years of age.

Methods and Results We used the 2001 to 2011 Nationwide Inpatient Sample. Rates of HF were calculated by patient and hospital characteristics. Survey logistic regression was used to estimate adjusted odds ratios representing the association between HF and each outcome, stratified by antepartum, delivery, and postpartum periods. Joinpoint regression was used to describe temporal trends in HF and in-hospital mortality. Over 50 million pregnancy-related hospitalizations were analyzed. The overall rate of HF was 112 cases per 100 000 pregnancy-related hospitalizations. Although postpartum encounters represented only 1.5% of pregnancy-related hospitalizations, ≈60% of HF cases occurred postpartum, followed by delivery (27.3%) and antepartum (13.2%). Among postpartum hospitalizations, there was a significant 7.1% (95% confidence interval, 4.4–9.8) annual increase in HF from 2001 to 2006, followed by a steady rate through 2011. HF rates among antepartum hospitalizations increased on average 4.9% (95% confidence interval, 3.0–6.8) annually from 2001 to 2011. Women with a diagnosis of HF were more likely to experience adverse maternal outcomes, as reflected by outcome-specific adjusted odds ratios during antepartum (2.7–25), delivery (6–195), and postpartum (1.5–6.6) periods.

Conclusions HF is associated with increased risk of maternal mortality and morbidities. During hospitalization, high-risk mothers need to be identified and surveillance programs developed before discharge.

背景技术心力衰竭（HF）是美国孕产妇发病和死亡的主要原因，但在产前，分娩和产后期间与HF相关的住院治疗的患病率，相关性和结果仍然未知。目的是检查13至49岁妇女中与妊娠相关的住院治疗中的HF患病率，相关性和结果。

方法与结果我们使用了2001年至2011年的全国住院患者样本。HF的发生率是根据患者和医院的特征来计算的。使用调查逻辑回归来估计调整的优势比，该比值代表了HF与每个结局之间的关联，并按产前，分娩和产后时期进行了分层。连接点回归用于描述心力衰竭和医院内死亡率的时间趋势。分析了超过5000万与怀孕相关的住院治疗。HF的总发生率为每10万例妊娠相关的住院病例112例。尽管产后s诊仅占妊娠相关住院的1.5％，但约60％的HF病例发生在产后，其次是分娩（27.3％）和产前（13.2％）。在产后住院治疗中，有7.1％（95％置信区间4.4–9）显着。

结论HF与孕产妇死亡和发病风险增加有关。在住院期间，需要确定高危母亲，并在出院前制定监测计划。