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Recording available 2/16-5/2
Recording available 2/16-5/2
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Abstract Award
Abstract Award
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Foundation Awardee

Poster Session 4

Category: Medical/Surgical/Diseases/Complications

Poster Session 4

(1051) Primary Immunodeficiency Drives Severe Maternal Morbidity: A Nationally Representative Cohort Study

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Objective:
To quantify the risk of severe maternal morbidity (SMM) associated with primary immunodeficiency (PI) during delivery hospitalizations in a nationally representative cohort. Although rare, PI includes a spectrum of genetic inherited immune disorders that may increase vulnerability to infection, autoimmunity, organ failure, and other life-threatening peripartum complications.

Study Design:
We conducted a retrospective cohort study using data from the National Inpatient Sample (2016–2022), a database capturing approximately 20% of hospital discharges in the United States. Delivery admissions, comorbidities, and SMM were identified through previously established ICD-10 procedure and diagnosis. PI diagnoses were identified using ICD-10 codes obtained from the American Academy of Allergy, Asthma & Immunology. Bivariate analyses were used to compare the prevalence of comorbidities and SMM indices between PI and non-PI groups. Inclusion criteria for the PI group includes patients hospitalized for childbirth between 2016 and 2022 and an ICD-10 code of PI. Exclusion criteria include missing key demographic or outcome variables needed for analysis. A multivariable binary logistic regression was used to assess the relationship of PI on SMM while controlling for the number of CI with diagnosis of PI as the primary exposure and SMM as the outcome of interest.

Results:
A total of 5,027,079 delivery hospitalizations were identified. Diagnosis of PI was found in 1,052 admissions. Several comorbidities are more common among patients with PI (Figure 1a).  SMM occurred in 10.4% of patients with PI versus 1.9% without, mostly driven by immune-related SMM (Figure 1b).  In the logistic regression model, PI was associated with SMM even after controlling for the number of CI (OR 3.02, 95% CI 2.43 – 3.73, p< 0.001).

Conclusion:
Patients with PI had a threefold increased odds of severe maternal morbidity even after controlling for comorbidities. These findings show a critical gap in perinatal risk stratification and underscore the need for early recognition and targeted care in this overlooked population.