(106) Maternal Morbidity and Mortality for Women with Concurrent Cancer Diagnoses at Time of Delivery Hospitalization

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: To estimate the prevalence in the United States of concurrent cancer diagnoses by cancer type at time of delivery and associated maternal morbidity and mortality.

Study Design: Using the National Inpatient Sample (NIS), we identified delivery-associated hospitalizations between 2007–2018. Concurrent cancer diagnoses were classified using Clinical Classification Software developed by the Agency for Healthcare Research and Quality (AHRQ). Main outcomes were severe maternal morbidity (using CDC definitions) and mortality during delivery hospitalization. We calculated adjusted rates and odds of cancer diagnosis, severe maternal morbidity, and maternal death during hospitalization using multivariable logistic regression model. All rates are reported per 100,000 deliveries.

Results: In our sample of 9,418,761 delivery-associated hospitalizations, 63 per 100,000 deliveries had a concurrent cancer diagnosis. The most common cancer types were breast (8.4), leukemia (8.4), Hodgkin’s lymphoma (7.4), non-Hodgkin’s lymphoma (5.4), and thyroid cancer (4.0). Risk of cancer increased steadily with maternal age (adjusted odds ratio [aOR] 1.05 per year, 95% confidence intervals [CI] 1.04, 1.05, Figure 1). Women with cancer were at significantly more risk for any severe maternal morbidity (aOR 5.27, 95% CI 4.80, 5.80) and maternal death (aOR 68.2, 95% CI 45.5, 102.0; Table 1). Women with leukemia, specifically, had the highest risk of adverse outcomes (Table 1).

Conclusion:

Women with cancer are at an increased risk of maternal morbidity and all-cause morbidity during delivery-associated hospitalization. As this population is anticipated to grow, a better understanding of risk can inform patient-centered care.

Primary & Presenting Author(s)

Alexandra C. Sundermann, MD, PhD (she/her/hers)
OBGYN Resident
Duke University Medical Center
Durham, North Carolina, United States

Coauthor(s)

Jennifer J. Cate, MD (she/her/hers)
MFM Fellow
Duke University
Durham, North Carolina, United States
AC
Alexa Campbell, MPH
Medical Student
Duke University Hospital
Chapel Hill, North Carolina, United States
Sarah K. Dotters-Katz, MD
Assistant Professor
Duke University Medical Center
Durham, North Carolina, United States
EM
Evan Myers, MD, MPH
Duke University Hospital
Durham, North Carolina, United States
Jerome J. Federspiel, MD, PhD
Duke University Hospital
Durham, North Carolina, United States