(148) Delivery Outcomes Among Patients With Neurofibromatosis in the United States 2016 - 2022

Much of the recent literature regarding neurofibromatosis in pregnancy is limited to case reports and small series. Our objective was to characterize current maternal and obstetric outcomes in pregnancies complicated by neurofibromatosis type 1 (NF1) using a national database.

Study Design:

We conducted a cross-sectional study using the U.S. National Inpatient Sample to identify delivery hospitalizations among patients with NF1 between 2016 and 2022. Maternal and obstetric outcomes were compared between patients with and without NF1 using adjusted logistic regression models accounting for demographic, clinical, and hospital characteristics. Associations were reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).

Results:

Among more than 25 million delivery hospitalizations, 3,515 involved patients with NF1 at a rate of 13.99 per 100,00 deliveries. The prevalence of NF1-affected deliveries remained stable over the study period [Figure 1]. Compared to patients without NF1, those with NF1 had significantly higher odds of severe maternal morbidity (aOR 1.91, 95% CI 1.05–3.47), hypertensive disorders of pregnancy (aOR 1.49, 95% CI 1.23–1.81), cesarean delivery (aOR 2.01, 95% CI 1.72–2.33), fetal growth restriction (aOR 2.87, 95% CI 2.26–3.65), and preterm birth (aOR 1.96, 95% CI 1.60–2.39). The greatest risk was seen for very preterm birth before 28 weeks (aOR 2.81, 95% CI 1.68–4.72). There was no significant increase in the risk of intrauterine fetal demise (aOR 1.64, 95% CI 0.74–3.63) or cerebrovascular complications [Table 1].

Conclusion:

The rate of deliveries affected by NF1 did not change significantly over time. Patients with NF1 are at increased risk for a broad range of adverse obstetric outcomes. Further research is needed to determine what clinical factors potentiate this risk.