Obstetrical and newborn outcomes among women with acute leukemias in pregnancy: a population-based study.
Autor: Nolan, Sabrina; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie
Publication year: 2020
The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
issn:1476-4954
doi: 10.1080/14767058.2019.1579188
Abstract:
Purpose: Acute leukemias (ALs) are rare but aggressive malignancies. The goal of our study was to determine the incidence, obstetrical, and newborn outcomes of ALs in pregnancy.Materials and methods: We performed a retrospective population-based cohort study on all births reported in the Health-Care Cost and Utilization Project-Nationwide Inpatient Sample between 1999 and 2014. We calculated the incidence of ALs in pregnancy and conducted multivariate logistic regression to obtain adjusted odds ratios for various maternal and newborn outcomes among this population compared to a nonaffected one.Results: We identified 291 maternal cases of ALs among 14,513,587 births, yielding an incidence of 2.01 per 100,000 births over the 15-year study period. There were approximately twice as many diagnoses of acute myeloid leukemia (AML) as compared to acute lymphoid leukemia (ALL). After adjusting for differing baseline characteristics and maternal and fetal deaths, we found that pregnant women with ALs were more likely to experience post-partum hemorrhage, to suffer from disseminated intravascular coagulation (DIC), to require transfusions, to have wound complications, and to experience venous thromboembolism (VTEs). Maternal death, preterm delivery, and intrauterine fetal death (IUFD) were more common in pregnant women with ALs.Conclusion: The incidence of ALs in pregnancy appears to be greater than what was previously believed. As it is associated with several adverse maternal and fetal outcomes, affected patients should be cared for in tertiary care institutions with access to high-risk obstetrical specialists, hematologists, and neonatologists.
Language: eng
Rights:
Pmid: 30773954
Tags: Humans; Female; Retrospective Studies; Infant, Newborn; Cohort Studies; Pregnancy; pregnancy; *Pregnancy Complications; leukemia; Pregnancy Outcome/epidemiology; *Leukemia/epidemiology; Acute leukemia; acute lymphoid leukemia; acute myeloid leukemia
Link: https://pubmed.ncbi.nlm.nih.gov/30773954/
