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Common Combinations of Pregestational Diagnosis and Pregnancy Complications

Objective Single pregestational diagnoses have been demonstrated to be associated with pregnancy-related complications. But, the effect of multiple diagnoses is understudied. The objective of this study is to determine the most common combinations of pregestational diagnoses and to determine if spec...

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Autores principales: Cao, Suzanne, Dong, Fanglong, Okekpe, C. Camille, Dombrovsky, Inessa, Valenzuela, Guillermo J, Roloff, Kristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642143/
https://www.ncbi.nlm.nih.gov/pubmed/34877216
http://dx.doi.org/10.7759/cureus.19239
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author Cao, Suzanne
Dong, Fanglong
Okekpe, C. Camille
Dombrovsky, Inessa
Valenzuela, Guillermo J
Roloff, Kristina
author_facet Cao, Suzanne
Dong, Fanglong
Okekpe, C. Camille
Dombrovsky, Inessa
Valenzuela, Guillermo J
Roloff, Kristina
author_sort Cao, Suzanne
collection PubMed
description Objective Single pregestational diagnoses have been demonstrated to be associated with pregnancy-related complications. But, the effect of multiple diagnoses is understudied. The objective of this study is to determine the most common combinations of pregestational diagnoses and to determine if specific combinations increase the risk of pregnancy-related complications. Study design We performed a cross-sectional study of the 2016 Healthcare Cost and Utilization Project’s National Inpatient Sample (HCUP NIS) database. Inclusion criteria were: Diagnosis-related groups assumed to be associated with delivery, and three or fewer International Classification of Diseases, Tenth Revision (ICD-10), clinical modification codes with a prevalence greater than or equal to 0.5%, or clinically important risk factors in Bateman’s co-morbidity index. Chi-squared analysis of combinations of pregestational diagnoses was performed to assess the relative risk of pregnancy-related complications. Results The 2016 database included 255,233 delivered pregnancies. The most common combinations of pregestational diagnoses involved advanced maternal age, prior cesarean delivery, obesity, and tobacco use. Most combinations did not demonstrate an increased risk for complications greater than the risk with a single diagnosis. In those with statistically significant risk, all were 3-fold or less except we noted a 4.4-fold higher risk (95% CI: 3.16-6.15) of preeclampsia in obese patients of advanced maternal age compared to patients who were only of advanced maternal age. Conclusion Our results revealed that common combinations of pregestational diagnoses, in general, do not increase the risk for common pregnancy-related complications greater than the risk with a single diagnosis. This is reassuring, given that women entering pregnancy with multiple co-morbidities are becoming more common.
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spelling pubmed-86421432021-12-06 Common Combinations of Pregestational Diagnosis and Pregnancy Complications Cao, Suzanne Dong, Fanglong Okekpe, C. Camille Dombrovsky, Inessa Valenzuela, Guillermo J Roloff, Kristina Cureus Obstetrics/Gynecology Objective Single pregestational diagnoses have been demonstrated to be associated with pregnancy-related complications. But, the effect of multiple diagnoses is understudied. The objective of this study is to determine the most common combinations of pregestational diagnoses and to determine if specific combinations increase the risk of pregnancy-related complications. Study design We performed a cross-sectional study of the 2016 Healthcare Cost and Utilization Project’s National Inpatient Sample (HCUP NIS) database. Inclusion criteria were: Diagnosis-related groups assumed to be associated with delivery, and three or fewer International Classification of Diseases, Tenth Revision (ICD-10), clinical modification codes with a prevalence greater than or equal to 0.5%, or clinically important risk factors in Bateman’s co-morbidity index. Chi-squared analysis of combinations of pregestational diagnoses was performed to assess the relative risk of pregnancy-related complications. Results The 2016 database included 255,233 delivered pregnancies. The most common combinations of pregestational diagnoses involved advanced maternal age, prior cesarean delivery, obesity, and tobacco use. Most combinations did not demonstrate an increased risk for complications greater than the risk with a single diagnosis. In those with statistically significant risk, all were 3-fold or less except we noted a 4.4-fold higher risk (95% CI: 3.16-6.15) of preeclampsia in obese patients of advanced maternal age compared to patients who were only of advanced maternal age. Conclusion Our results revealed that common combinations of pregestational diagnoses, in general, do not increase the risk for common pregnancy-related complications greater than the risk with a single diagnosis. This is reassuring, given that women entering pregnancy with multiple co-morbidities are becoming more common. Cureus 2021-11-03 /pmc/articles/PMC8642143/ /pubmed/34877216 http://dx.doi.org/10.7759/cureus.19239 Text en Copyright © 2021, Cao et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Obstetrics/Gynecology
Cao, Suzanne
Dong, Fanglong
Okekpe, C. Camille
Dombrovsky, Inessa
Valenzuela, Guillermo J
Roloff, Kristina
Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title_full Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title_fullStr Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title_full_unstemmed Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title_short Common Combinations of Pregestational Diagnosis and Pregnancy Complications
title_sort common combinations of pregestational diagnosis and pregnancy complications
topic Obstetrics/Gynecology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8642143/
https://www.ncbi.nlm.nih.gov/pubmed/34877216
http://dx.doi.org/10.7759/cureus.19239
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