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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
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Poster Session 4

Category: Medical/Surgical/Diseases/Complications

Poster Session 4

(1287) Rising Acute Myocardial Infarction in Pregnancy: National Trends, Risk Factors, and Maternal Health Disparities

Thursday, February 12, 2026
3:30 PM - 5:00 PM  

    Submitting Author and Presenting Author(s)

  • Vanessa Kirschner, BS

    David Geffen School of Medicine at University of California, Los Angeles (UCLA)
    LOS ANGELES, California, United States

    • Coauthor(s)

  • Prisca C. Diala, MD (she/her/hers)

    Department of Obstetrics and Gynecology, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
    Los Angeles, California, United States

  • ME

    Masoureh Eghbali, PhD

    David Geffen School of Medicine at University of California, Los Angeles (UCLA)
    Los Angeles, California, United States

  • BB

    Brittany Burton, MD

    David Geffen School of Medicine at University of California, Los Angeles (UCLA)
    Los Angles, California, United States

  • Yalda Afshar, MD, PhD (she/her/hers)

    David Geffen School of Medicine at University of California, Los Angeles (UCLA)
    Los Angeles, California, United States

Objective:
To determine recent trends in the incidence of acute myocardial infarction (AMI) during pregnancy and the puerperium in the United States and identify independent sociodemographic, clinical, and obstetric risk factors using a nationally representative cohort, with the goal of informing targeted prevention, improving risk stratification, and guiding the development of integrated care models to reduce maternal morbidity and mortality, particularly among high-risk populations.

Study Design:
We conducted a retrospective cohort study using the National Inpatient Sample from 2018–2020. Pregnancy-related hospitalizations were identified using ICD-10 codes, and AMI events during pregnancy or the puerperium were included. Survey weights generated national estimates. Multivariable logistic regression identified independent predictors of AMI, adjusting for demographic, clinical, and hospital characteristics.

Results:
Among 11,079,833 pregnancy-related hospitalizations, 2,225 involved AMI (20.1 per 100,000), with incidence increasing over time (Fig 1). Patients with AMI were more likely to be older, Black, publicly insured, and from the lowest income quartile (Fig 2A). Independent predictors included chronic hypertension (aOR 25.5, 95% CI 15.3–42.6), chronic kidney disease (aOR 11.5, 95% CI 7.2–17.3), coagulopathy (aOR 3.6, 95% CI 2.5–5.1), drug use (aOR 2.4, 95% CI 1.7–3.5), and Black race (aOR 1.5, 95% CI 1.1–2.0). Obstetric complications included eclampsia (aOR 23.2, 95% CI 13.9–38.9), preeclampsia (aOR 2.4, 95% CI 1.8–3.1), and postpartum infection (aOR 6.0, 95% CI 4.5–8.1). Cesarean delivery was associated with decreased odds of AMI (aOR 0.63, 95% CI 0.49–0.81, Fig 2B).

Conclusion:
The rising incidence of AMI in pregnancy underscores the urgent need for targeted interventions. Our findings highlight key sociodemographic and clinical risk factors, supporting early recognition, improved risk stratification, and integrated obstetric–cardiology care to mitigate severe maternal morbidity and mortality.