Pregnancy, delivery and neonatal outcomes in women with gastrointestinal system cancer in pregnancy. An evaluation of a population database.

Amikam, Uri; Badeghiesh, Ahmad; Baghlaf, Haitham; Brown, Richard; Dahan, Michael H.

Gastrointestinal system (GIS) cancer in pregnancy is a rare disease. Our aim was to evaluate the association between this type of cancer and pregnancy, delivery and neonatal outcomes. We conducted a retrospective population-based cohort study using the Healthcare Cost and Utilization Project, Nation-wide Inpatient Sample (HCUP-NIS). We included all women who delivered or had a maternal death in the US between 2004 and 2014. We compared women with an ICD-9 diagnosis of GIS cancer to those without. Pregnancy, delivery, and neonatal outcomes were compared between the two groups. A total of 9,096,788 women met inclusion criteria. Amongst them, 194 women (2/100,000) had a diagnosis of GIS cancer during pregnancy. Women with GIS cancer, compared to those without, were more likely to be Caucasian, older than 35 years of age, and to suffer from obesity, chronic hypertension, pregestational diabetes and thyroid disease. The cancer group had a lower rate of spontaneous vaginal delivery (aOR 0.2, 95 % CI 0.13–0.27, p<0.001), and a higher rate of preterm delivery (aOR 1.85, 95 % CI 1.21–2.82, p=0.04), and of maternal complications such as blood transfusion (aOR 24.7, 95 % CI 17.11–35.66, p<0.001), disseminated intravascular coagulation (aOR 14.56, 95 % CI 3.56–59.55, p<0.001), venous thromboembolism (aOR 9.4, 95 % CI 2.3–38.42, p=0.002) and maternal death (aOR 8.02, 95 % CI 2.55–25.34, p<0.001). Neonatal outcomes were comparable between the two groups. Women with a diagnosis of GIS cancer in pregnancy have a higher incidence of maternal complications including maternal death, without any differences in neonatal outcomes.

UNITED States; CONFIDENCE intervals; AGE distribution; PREGNANT women; RETROSPECTIVE studies; ACQUISITION of data; RACE; GASTROINTESTINAL tumors; PREGNANCY outcomes; RISK assessment; VAGINA; PREGNANCY complications; MEDICAL records; DESCRIPTIVE statistics; DELIVERY (Obstetrics); ODDS ratio; LABOR complications (Obstetrics); COMORBIDITY; PREMATURE labor; DISEASE risk factors; DISEASE complications

Journal of Perinatal Medicine, 2024, Vol 52, Issue 1, p50

0300-5577

Academic Journal

10.1515/jpm-2023-0038