Maternal implications of fetal anomalies: a population-based cross-sectional study

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Public Health

Background:

• Fetal anomalies are known to increase maternal morbidity risks.
• Specific risks associated with different fetal anomaly types remain poorly defined.

Purpose of the Study:

• To investigate adverse maternal health outcomes in relation to specific fetal anomaly types.
• To quantify the risk of severe maternal morbidity (SMM) based on fetal anomaly classification.

Main Methods:

• Analysis of US vital statistics Live Birth/Infant Death data from 2011-2020.
• Inclusion of pregnancies at or beyond 20 weeks gestation.
• Definition of SMM as ICU admission, transfusion, uterine rupture, or hysterectomy.
• Comparison of SMM risk between pregnancies with specific fetal anomalies and those without.
• Utilized modified Poisson regression for adjusted relative risks (aRR) and marginal standardization for adjusted risk differences (aRDs).

Main Results:

• All analyzed fetal anomalies, except gastroschisis and limb anomalies, were linked to increased SMM risk.
• Anencephaly and omphalocele showed the highest increased relative risks for SMM.
• Absolute risk increases for SMM were observed across most fetal anomaly types, with anencephaly and omphalocele demonstrating the largest differences.

Conclusions:

• Fetal anomalies are significantly associated with adverse maternal health outcomes, including severe maternal morbidity.
• The magnitude of SMM risk is dependent on the specific type of fetal anomaly.
• Informing mothers about potential maternal health implications of fetal anomalies is essential for shared decision-making in pregnancy management.