TY - JOUR
T1 - Complications of Delivery Among Mothers With Spina Bifida
AU - Shepard, Courtney L.
AU - Yan, Phyllis L.
AU - Kielb, Stephanie J
AU - Wittmann, Daniela A.
AU - Quint, Elisabeth H.
AU - Kraft, Kate H.
AU - Hollingsworth, John M.
N1 - Funding Information:
The authors would like to thank Lindsey Admon, M.D., M.S. (National Clinician Scholars Program, University of Michigan Institute for Healthcare Policy and Innovation and the US Department of Veteran Affairs, Ann Arbor) for her contribution to designing this research study and editing the manuscript.
Funding Information:
Source of Funding: This research was supported by a T-32 grant from the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases (grant number 5T32DK007782-17).
Publisher Copyright:
© 2018
PY - 2019/1
Y1 - 2019/1
N2 - Objective: To determine rates and types of peripartum morbidity among delivering women with spina bifida (SB) compared to those without SB. The rates of pregnancy and delivery among women with SB have been significantly increasing. Current knowledge of peripartum outcomes for these women is limited. Methods: Using 2004-2013 National Inpatient Sample data, we identified all hospitalizations for delivery, distinguishing between women with and without SB. Using a code-based algorithm, we determined whether a complication occurred during the hospitalization. We then fit a series of multivariable logistic models to examine for associations between a complication occurrence during vaginal or cesarean delivery and a woman's SB status. Results: We identified 38,319,814 weighted admissions for delivery, 9516 of which were made by women with SB. Women with SB had a significantly higher rate of cesarean delivery than women without this diagnosis (53% vs 32%, P <.001). The 46.7% of women with SB who delivered vaginally did not have significantly increased odds of a complication associated with their delivery compared to women without SB [odds ratio 1.15, 95% confidence interval 0.99-1.34, P =.066]. However, women with SB who underwent a cesarean delivery did have higher odds of morbidity compared to those without (odds ratio 1.49, 95% confidence interval 1.25-1.78, P <.001). Common complications included preterm delivery, urinary tract infection, hematologic event, and blood transfusion. Conclusion: Compared to women without SB, those with SB deliver more frequently by cesarean section and have higher odds of morbidity associated with cesarean delivery, but not vaginal delivery.
AB - Objective: To determine rates and types of peripartum morbidity among delivering women with spina bifida (SB) compared to those without SB. The rates of pregnancy and delivery among women with SB have been significantly increasing. Current knowledge of peripartum outcomes for these women is limited. Methods: Using 2004-2013 National Inpatient Sample data, we identified all hospitalizations for delivery, distinguishing between women with and without SB. Using a code-based algorithm, we determined whether a complication occurred during the hospitalization. We then fit a series of multivariable logistic models to examine for associations between a complication occurrence during vaginal or cesarean delivery and a woman's SB status. Results: We identified 38,319,814 weighted admissions for delivery, 9516 of which were made by women with SB. Women with SB had a significantly higher rate of cesarean delivery than women without this diagnosis (53% vs 32%, P <.001). The 46.7% of women with SB who delivered vaginally did not have significantly increased odds of a complication associated with their delivery compared to women without SB [odds ratio 1.15, 95% confidence interval 0.99-1.34, P =.066]. However, women with SB who underwent a cesarean delivery did have higher odds of morbidity compared to those without (odds ratio 1.49, 95% confidence interval 1.25-1.78, P <.001). Common complications included preterm delivery, urinary tract infection, hematologic event, and blood transfusion. Conclusion: Compared to women without SB, those with SB deliver more frequently by cesarean section and have higher odds of morbidity associated with cesarean delivery, but not vaginal delivery.
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U2 - 10.1016/j.urology.2018.04.045
DO - 10.1016/j.urology.2018.04.045
M3 - Article
C2 - 29908216
AN - SCOPUS:85056780070
SN - 0090-4295
VL - 123
SP - 280
EP - 286
JO - Urology
JF - Urology
ER -