Abstract
Objectives: Women with Down syndrome (DS) suffer from several
health issues, however, their fecundity is not affected. Despite that,
there are no studies in the literature to address pregnancy, delivery,
or neonatal outcomes among women with DS.
Design: We conducted a retrospective study using the Health
Care Cost and Utilization Project-Nationwide Inpatient Sample Database
over 11 years from 2004 to 2014.
Methods: 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 and health insurance
type to women without DS (control) at a ratio of 1:4. A multivariant
logistic regression model was used to adjust for statistically
significant variables (P-value < 0.5). Results: There
were a total of 9,096,788 deliveries during the study period. Of those,
185 pregnant women were found to have DS. The matched control group was
740. Maternal pregnancy risks mostly did not differ between those with
and without DS including pregnancy-induced PIH, gestational diabetes,
preeclampsia, PPROM, chorioamnionitis, cesarean section, operative
vaginal delivery, or blood transfusion (P >0.05, all).
However, they were at extremely increased risk of delivering prematurely
(aOR 3.86, 95% CI 1.25-11.93), and to have adverse neonatal outcomes
such as small for gestational age (aOR 13.13, 95% CI 2.20-78.41),
intrauterine fetal demise (aOR 20.97, 95% CI 1.86-237.02), and
congenital anomalies (aOR 9.59, 95% CI 1.47-62.72).
Conclusion: Women with DS should be counseled about their
increased risk of premature delivery and adverse neonatal outcomes.