1715. Coccidioidomycosis Outcomes Among Hospitalized Pregnant and Postpartum Women—California, 2000–2016

Abstract

BackgroundCoccidioidomycosis (CM) in pregnancy has been associated with severe, disseminated disease. Publications are largely limited to case reports. Using California administrative hospital and birth registry data, we describe maternal and neonatal outcomes among pregnant and post-partum women hospitalized with CM.MethodsWe extracted California records from 2000 to 2016 for women 14–45 years, hospitalized with CM discharge codes; and used the birth registry to identify women who were pregnant or post-partum (≤30 days of childbirth) during their hospitalization. We used chi-squared tests to compare pregnant/post-partum women hospitalized with CM to nonpregnant women hospitalized with CM, and birth outcomes for infants of mothers hospitalized with CM to other California infants. We used multivariable logistic regression, controlling for demographics and comorbidities, to determine the risk of pregnancy on CM dissemination.ResultsWe identified 2,372 women with ≥1 CM hospitalization; 187 (8%) were pregnant/post-partum and there were 188 infants (one set of twins). Pregnant/post-partum women were more likely to be Hispanic (59% vs. 44%, P < 0.01), younger (median age 27 vs. 35 years, P < 0.01), without comorbidities (60% vs. 36%, P < 0.01), and have disseminated CM (32% vs. 21%, P < 0.01) than nonpregnant women. Hospitalized pregnant/post-partum women with CM were more likely to have CM dissemination compared with hospitalized non-pregnant women with CM (odds ratio 2.0, 95% confidence interval 1.4–2.8). Among infants of pregnant women hospitalized with CM, 18 (10%) were born < 34 weeks gestational age and 11 (8%) of 134 term (>37 weeks) infants had a birth weight <2,500 g; compared with 3% and 3% (P < 0.01) of other California liveborns, respectively.ConclusionThis study is the largest cohort of pregnant women hospitalized with CM to date and corroborates that pregnant/post-partum women are more likely to develop disseminated CM than non-pregnant women. Their infants may be more likely to be born <34 weeks gestational age and have a low birth weight. This highlights the need for clinicians caring for pregnant/post-partum women who may live or travel to an area where CM occurs to be aware of the risks for these women and their infants.Disclosures All authors: No reported disclosures.