275 Non-obstetric postoperative complications among pregnant patients in the national surgical quality improvement program, 2005-2012

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To determine whether pregnant patients have higher risk of major 30-day postoperative complications compared with non-pregnant patients after non-obstetric surgery. A retrospective analysis of the National Surgical Quality Improvement program from 2005-2012 (after which pregnancy status was not collected). We included women 18-51 years, without surgery in the preceding 30 days, who underwent a non-obstetrical operation (i.e., no cesarean delivery, peripartum hysterectomy). We assessed whether pregnancy status was associated with increased risk of composite of 30-day major postoperative complications. Because surgical decision-making and risk of complications may vary by comorbidity status and most pregnant patients are healthy, we examined these associations relative to American Society of Anesthesiologists (ASA) physical status. Modified Poisson regression was used, adjusting for age, BMI, tobacco use, race, case urgency, inpatient status, operative time, work relative value unit, and procedure year, and ASA physical status Among 354,251 patients, 3,655 (1%) were pregnant. Most patients were healthy (ASA 1 or 2: pregnant, 87% vs. non-pregnant, 77%; p<0.001). The overall incidence of 30-day major postoperative complication was 6%, which was the same regardless of pregnancy status. Compared with non-pregnant patients, pregnant patients were not at higher risk of major postoperative complications after non-obstetric surgery (aRR: 1.07; 95% CI: 0.92 to 1.25). Findings remained similar when analysis was limited to the two most common non-obstetric surgical procedures during pregnancy, appendectomy (36%) and cholecystectomy (19%). However, healthy pregnant patients (ASA class 1 or 2) were at higher risk of postoperative complications compared to healthy non-pregnant patients (aRR: 1.33; 95% CI: 1.10 to 1.63). Pregnant patients were generally not at higher risk of major postoperative complications following non-obstetric surgery. However, among a subset of healthy patients, pregnancy may pose an increased risk of complications