Maternal and Fetal Outcomes Associated With Infective Endocarditis in Pregnancy

Infective endocarditis (IE) is a rare but serious infection complicating pregnancy. However, its management and outcomes in this population remain unclear.

A recent study searched The National Readmissions Database to obtain the relevant data between October 2015 and October 2018. It identified admissions for IE in female patients of reproductive age using Billing codes. The study compared demographic characteristics, comorbidities, and outcomes between maternity-associated and nonmaternity-associated IE patients and obstetric patients who delivered with and without IE. 

The study identified 12602 reproductive-aged female patients with a diagnosis of IE, of which 382 were maternity-associated. 117 (among 382) occurred during a delivery admission. Contrasting the patients with nonmaternity-associated IE, maternity-associated infection was associated with younger age, Medicaid coverage, and drug use. However, the mortality was comparable. Contrasting with patients who delivered without IE, IE complicating delivery showed worse maternal and fetal outcomes, including maternal mortality and preterm birth.

Thus, Maternity-associated IE does not have an additional risk for adverse outcomes over nonmaternity-associated infection. Patients who deliver with IE have worse maternal and fetal outcomes than those not complicated by IE.

Dagher MM, Eichenberger EM, Addae-Konadu KL, Dotters-Katz SK, Kohler CL, Fowler VG, Federspiel JJ. Maternal and Fetal Outcomes Associated With Infective Endocarditis in Pregnancy. Clin Infect Dis. 2021 Nov 2;73(9):1571-1579. DOI: 10.1093/cid/ciab533. PMID: 34111290; PMCID: PMC8563217.