Abstract 16523: Trends and Outcomes of Preeclampsia Hospitalizations According to the Nationwide Inpatient Sample 2016-2020; An Updated Retrospective Population-Based Study

Introduction: Preeclampsia occurs in about 5-8% of pregnancies and is a leading cause of maternal morbidity and mortality. We aimed to study the inpatient population with preeclampsia.

Hypothesis: The disparity gap remains apparent in maternal health, and minority populations would have poorer outcomes

Methods: We conducted a retrospective analysis using the 2016 to 2020 Nationwide Inpatient Sample (NIS) database. Using ICD-10 codes, we identified all hospitalizations with a primary diagnosis of preeclampsia. We adjusted for confounders and used a multivariate logistic regression model to estimate the odds ratio (adjusted odds ratios (aOR)) of our outcomes of interest.

Results: There were 126,255 primary preeclampsia hospitalizations (PRE) during the study period, of which 2.2% (2,736) had eclampsia (ECL). There was an increase in the number of PRE hospitalizations from 24459 (24.5 per 1000 deliveries) in 2016 to 28448 (28.4 per 1000 pregnancies) in 2020 (p <0.0001). Contrary to PRE admissions, there was a considerable decrease in hospitalizations or diagnoses for ECL from 958 (1 per 1000 deliveries) in 2016 to 417 (0.4 per 1000 deliveries) in 2020 (p<0.0001). The mean age was 29 years (SD=6.3), and the mean length of hospitalization was 4 days (SD=3.6). Compared to their Caucasian counterparts, the risk of eclampsia was higher in the minority populations, with aOR of 2.4 (CI 2.1-2.6, p<0.0001) in the Black, 1.3 (CI 1.1-1.4, p<0.0001) in the Hispanic, 1.01 (CI 0.8-1.3, p=0.7) in the Asian, and 1.7 (CI 1.1-2.4, p<0.0001) in the Native-American populations. Furthermore, the PRE group had a higher likelihood of postpartum acute kidney injury, 9.6 (CI 7.8-11.6, p<0.0001), and postpartum cardiomyopathy 3.3 (2.9-3.9, p<0.0001).

Conclusions: Our five-year inpatient analysis revealed that while preeclampsia hospitalizations increased, eclampsia decreased. It also highlighted a higher likelihood of eclampsia in Black, Hispanic, and Native-American women and a subsequent increased risk for postpartum cardiomyopathy and acute kidney injury. Tailoring individualized maternal cardiovascular care based on risk stratification is crucial in these populations.