Burden of maternal and fetal outcomes among pregnant cancer survivors during delivery hospitalizations in the United States

Abstract

Abstract Existing studies on pregnancy-related outcomes among cancer survivors are limited by sample size or specificity of the cancer type. This study estimated the burden of adverse maternal and fetal outcomes among pregnant cancer survivors using a national database. This study was a retrospective analysis of National Inpatient Sample collected during 2010–2014. Multivariate regression models were used to calculate odds ratios for maternal and fetal outcomes. The study included a weighted sample of 64,506 pregnant cancer survivors and 18,687,217 pregnant women without cancer. Pregnant cancer survivors had significantly higher odds for death during delivery hospitalization, compared to pregnant women without cancer (58 versus 5 deaths per 100,000 pregnancies). They also had higher odds of severe maternal morbidity (aOR 2.00 [95% CI 1.66–2.41]), cesarean section (aOR 1.27 [95% CI 1.19–1.37]), labor induction (aOR 1.17 [95% CI 1.07–1.29]), pre-eclampsia (aOR 1.18 [95% CI 1.02–1.36]), preterm labor (aOR 1.55 [95% CI 1.36–1.76]), chorioamnionitis (aOR 1.45 [95% CI 1.15–1.82]), postpartum infection (aOR 1.68 [95% CI 1.21–2.33]), venous thromboembolism (aOR 3.62 [95% CI 2.69–4.88]), and decreased fetal movements (aOR 1.67 [95% CI 1.13–2.46]). This study showed that pregnancy among cancer survivors constitutes a high-risk condition requiring advanced care and collective efforts from multiple subspecialties.