Pregnancy Outcome in Women Following Splenectomy

Abstract

To investigate pregnancy outcome of patients following splenectomy. A retrospective study comparing pregnancies of women who have and have not undergone splenectomy was performed. The study investigated a select population representing the south of Israel. Women lacking antenatal care as well as those having multiple gestations were excluded from the analysis. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders. During the study period, there were 219,656 deliveries, of which 150 occurred in women who underwent splenectomy. Postsplenectomy women tended to be older, were more likely to be Jewish, and had a lower number of deliveries and an earlier gestational age at delivery. Higher rates of fertility treatment, previous cesarean delivery, and severe preeclampsia were found among postsplenectomy women. In addition, splenectomy was significantly associated with pregnancy and labor complications, such as cesarean delivery, pneumonia during pregnancy, and complications of anesthesia and sedation during labor. Using a multivariate analysis with backward elimination, the following conditions were independently associated with splenectomy: previous cesarean delivery (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.1-2.3, p=0.039), fertility treatment (OR 2.6, 95% CI 1.3-5.4, p=0.008), preterm delivery (OR 1.9, 95% CI 1.3-3.1, p=0.003), and maternal age (OR 1.04, 95% CI 1.015-1.07, p=0.002). After controlling for possible confounders by using another multivariate analysis with preterm delivery as the outcome variable, splenectomy was found to be an independent risk factor for preterm delivery (OR 2.1, 95% CI 1.4-3.3, p=0.001). Splenectomy is an independent risk factor for preterm delivery.