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Pregnancy, delivery, and neonatal outcomes among women living with Down syndrome: a matched cohort study, utilizing a population database

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

We utilized a population database to address the paucity of data around pregnancy outcomes in women with Down syndrome (DS).

Methods

We conducted a retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample Database over 11 years, from 2004 to 2014. A delivery cohort was created using ICD-9 codes. ICD-9 code 758.0 was used to extract the cases of maternal DS. Pregnant women with DS (study group) were matched based on age, race, income, and health insurance type to women without DS (control) at a ratio of 1:20.

Results

There were a total of 9,096,788 deliveries during the study period. Of those, 184 pregnant women were found to have DS. The matched control group was 3680. After matching, most of the pregnancy and delivery outcomes, such as pregnancy-induced hypertension, gestational diabetes, preterm premature rupture of membrane, chorioamnionitis, cesarean section, operative vaginal delivery, or blood transfusion were similar between participants with and without DS. However, patients with DS were at increased risk of giving birth prematurely (aOR 3.09, 95% CI 2.06–4.62), and having adverse neonatal outcomes such as small for gestational age (aOR 2.70, 95% CI 1.54–4.73), intrauterine fetal demise (aOR 22.45, 95% CI 12.02–41.93), congenital anomalies (aOR 7.92, 95% CI 4.11–15.24), and fetal chromosomal abnormalities.

Conclusion

Neonates to mothers with DS are at increased risk of prematurity and other neonatal adverse outcomes. Hence, counseling patients with DS about these risks and increased antenatal surveillance is advised.

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Data availability

Study utilized data from the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database (HCUP-NIS).

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Funding

There are no financial, personal, political, intellectual, or religious interests to declare.

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Authors and Affiliations

  1. Division of Maternal-Fetal Medicine, Obstetrics and Gynaecology, McGill University, Montreal, Canada

    Abdullah Alnoman & Haitham A. Baghlaf

  2. King Abdulaziz University, Jeddah, Saudi Arabia

    Abdullah Alnoman & Ahmad M. Badeghiesh

  3. Division of Reproductive Endocrinology and Infertility, Obstetrics and Gynaecology, Western University, London, Canada

    Ahmad M. Badeghiesh

  4. Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Canada

    Magdalena Peeva

  5. Division of Reproductive Endocrinology and Infertility, MUHC Reproductive Center, McGill University, Montreal, Canada

    Michael H. Dahan

Authors
  1. Abdullah Alnoman
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  2. Haitham A. Baghlaf
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  3. Ahmad M. Badeghiesh
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  4. Magdalena Peeva
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Contributions

AA, HB, AB, and MD designed the study. HB, AB had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. HB, AB acquired the data and performed statistical analysis. AA, MP wrote and drafted the manuscript. MD contributed to the study design and to the statistical analysis and interpretation of data. All authors provided critical revision of the manuscript.

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Correspondence to Abdullah Alnoman.

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Alnoman, A., Baghlaf, H.A., Badeghiesh, A.M. et al. Pregnancy, delivery, and neonatal outcomes among women living with Down syndrome: a matched cohort study, utilizing a population database. Arch Gynecol Obstet (2023). https://doi.org/10.1007/s00404-023-07208-0

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  • DOI: https://doi.org/10.1007/s00404-023-07208-0

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