ResearchObstetricsNeurofibromatosis type 1 and pregnancy complications: a population-based study
Section snippets
Data source
The Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP), sponsored by the Agency for Healthcare Research and Quality (AHRQ; Rockville, MD), collects administrative and clinical data on US hospital discharges yearly. The 2009 NIS, the most recent available data set, contains discharge data from 1050 hospitals in 44 states, approximating a 20% stratified sample of all nonfederal hospitals. Information available from the NIS includes up to 15 International
Results
We identified 19,750,702 pregnancy-related admissions that occurred between 1988 and 2009. Of these, 1553 were associated with a diagnosis of NF1; 1248 (80.4%) of NF1 admissions were also associated with a delivery. The proportion of delivery-associated hospitalizations associated with a diagnosis of NF1 was approximately 1 in 10,000. Table 1 summarizes the demographic characteristics of both the NF1 and general obstetric populations. As expected, the majority of women (80.8%) were between 20
Comment
In our study of more than 1500 pregnancy-related hospitalizations in patients with NF1, we found that pregnant women with NF1 have higher odds of gestational hypertension, preeclampsia, IUGR, and cerebrovascular complications. These risks persisted despite younger age and adjusting for multiple confounding factors such as preexisting chronic hypertension, diabetes, and renal disease. Because rates of chronic hypertension and renal artery stenosis are known to be higher in patients with NF1,
Acknowledgments
The purchase of databases and computing supplies was supported by the John and Cyndy Leahy Fellowship Fund. The corresponding author is grateful to Dr Robert Martuza of Massachusetts General Hospital and the Massachusetts General Hospital Neurosurgical Service for generous financial support of relevant coursework at the Harvard School of Public Health. The authors also thank Vanessa Merker, BS, of Massachusetts General Hospital, for assistance editing this manuscript.
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A.R.T. received support from the John and Cyndy Leahy Fellowship Fund for the submitted work. The other authors report no conflict of interest. The funders had no role in the study design, data collection, data interpretation, or writing of the report.
Cite this article as: Terry AR, Barker FG II, Leffert L, et al. Neurofibromatosis type 1 and pregnancy complications: a population-based study. Am J Obstet Gynecol 2013;209:46.e1-8.