Background and Aims Persons with rheumatoid arthritis (RA) have an increased risk of obstetric-associated complications, as well as long-term cardiovascular (CV) risk. Hence, the aim was to evaluate the association of RA with acute CV complications during delivery admissions. Methods Data from the National Inpatient Sample (2004–2019) were queried utilizing ICD-9 or ICD-10 codes to identify delivery hospitalizations and a diagnosis of RA. Results A total of 12 789 722 delivery hospitalizations were identified, of which 0.1% were among persons with RA (n = 11 979). Individuals with RA, vs. those without, were older (median 31 vs. 28 years, P < .01) and had a higher prevalence of chronic hypertension, chronic diabetes, gestational diabetes mellitus, obesity, and dyslipidaemia (P < .01). After adjustment for age, race/ethnicity, comorbidities, insurance, and income, RA remained an independent risk factor for peripartum CV complications including preeclampsia [adjusted odds ratio (aOR) 1.37 (95% confidence interval 1.27–1.47)], peripartum cardiomyopathy [aOR 2.10 (1.11–3.99)], and arrhythmias [aOR 2.00 (1.68–2.38)] compared with no RA. Likewise, the risk of acute kidney injury and venous thromboembolism was higher with RA. An overall increasing trend of obesity, gestational diabetes mellitus, and acute CV complications was also observed among individuals with RA from 2004–2019. For resource utilization, length of stay and cost of hospitalization were higher for deliveries among persons with RA. Conclusions Pregnant persons with RA had higher risk of preeclampsia, peripartum cardiomyopathy, arrhythmias, acute kidney injury, and venous thromboembolism during delivery hospitalizations. Furthermore, cardiometabolic risk factors among pregnant individuals with RA rose over this 15-year period.

中文翻译：

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分娩期间类风湿性关节炎和心血管并发症：美国住院患者分析

背景和目标 类风湿性关节炎 (RA) 患者发生产科相关并发症以及长期心血管 (CV) 风险增加。因此，目的是评估 RA 与入院期间急性心血管并发症的关联。方法 使用 ICD-9 或 ICD-10 代码查询全国住院患者样本（2004-2019 年）的数据，以确定分娩住院情况和 RA 的诊断。结果 共确定 12 789 722 例分娩住院患者，其中 0.1% 为 RA 患者（n = 11 979）。与未患有 RA 的个体相比，患有 RA 的个体年龄更大（中位 31 岁与 28 岁，P < .01），并且慢性高血压、慢性糖尿病、妊娠糖尿病、肥胖和血脂异常的患病率更高（P < .01）。 01）。调整年龄、种族/族裔、合并症、保险和收入后，RA仍然是围产期心血管并发症的独立危险因素，包括先兆子痫[调整后的优势比（aOR）1.37（95%置信区间1.27-1.47）]、围产期心肌病[与无 RA 相比，aOR 2.10 (1.11–3.99)] 和心律失常 [aOR 2.00 (1.68–2.38)]。同样，RA 发生急性肾损伤和静脉血栓栓塞的风险也较高。2004年至2019年间，RA患者的肥胖、妊娠糖尿病和急性心血管并发症也呈总体增加趋势。就资源利用而言，类风湿性关节炎患者分娩的住院时间和住院费用较高。结论 RA孕妇在分娩住院期间发生子痫前期、围产期心肌病、心律失常、急性肾损伤、静脉血栓栓塞的风险较高。此外，在这 15 年期间，患有 RA 的孕妇的心脏代谢危险因素有所增加。