(1140) Evaluating the relationship between fetal aneuploidy, severe maternal morbidity and hypertensive diseases in pregnancy

Objective:
To assess whether fetal aneuploidy (FA) is independently associated with increased frequency of severe maternal morbidity (SMM) and hypertensive diseases in pregnancy (HDP) outcomes relative to delivery of non-aneuploid pregnancies.

Study Design:
This cross-sectional study utilized the most recent United States’ National Inpatient Sample dataset, which was queried for delivery admissions between 2016-2022. Women with ICD-10 codes for pregnancy complicated by FA (O35.1*) diagnosed on delivery admission were compared with those without. SMM was defined as presence of at least one Centers for Disease Control and Prevention severe maternal morbidity indicator. Comorbidity index (CI) was established based on prior report. Bivariate analyses were used to evaluate the association of FA and SMM and HDP. Logistic regression was performed to model the association between aneuploidy and severe maternal morbidity, controlling for the presence of CI. A second logistic regression model was made to assess the association between aneuploidy and HDP, while controlling for the presence of CI without HDP indicators.

Results:
Of 5,038,140 deliveries, 6,144 involved FA. The rate of SMM was similar in pregnancy with and without FA (2.2 vs. 1.9%, p 0.07). HDP was more common in pregnancy with FA compared to pregnancy without (14.8 vs. 12.9%, p< 0.001). In the logistic regression model, FA is not associated with SMM when controlled for CI (OR 1.03, 95% CI 0.96 – 1.11, p 0.33). When controlled for CI without HDP indicators, fetal aneuploidy is associated with higher risk of HDP (OR 1.66, 95% CI 1.53 – 1.79, p< 0.001).

Conclusion:

While there is no association of FA with SMM, the analyses of this large contemporary cohort showed that FA is an independent predictor for HDP. Counseling on potential maternal risk should be considered in pregnancy with FA.