Abstract
BackgroundWhether nonobstetric surgery during gestation is associated with a higher risk of spontaneous abortion or adverse delivery outcomes is still unclear.MethodsWe performed a retrospective case-control study using a Longitudinal Health Insurance Database (LHID 2000) containing claim-data of 1 million randomly selected beneficiaries. We compared the incidences and estimated the adjusted odds ratios (aOR) with 95% confidence interval (95% CI) for spontaneous abortion, adverse delivery outcomes, cesarean delivery, and prolonged hospital stay to determine the risk of adverse outcomes in women who had nonobstetric surgery during gestation as compared to those who did not have any surgery during gestation.ResultsAfter exclusion, we were left with 114,852 delivery and 3999 abortion cases in our study; and 462 (0.39%) of them had nonobstetric surgery under general or regional anesthesia during pregnancy. The leading surgeries were repair of cervical os (33.12%), appendectomy (17.32%), ovarian surgeries (13.64%), and fixation of fractured bone (8.01%).The risk of spontaneous abortion (4.23% vs. 2.43%, aOR:1.53; 95% CI: 1.01–2.31), antepartum hemorrhage (7.14% vs. 2.83%, aOR: 2.51; 95% CI: 1.74–3.61), pre-eclampsia/eclampsia (2.60% vs. 1.01%, aOR: 2.35; 95% CI: 1.30–4.23), gestational diabetes (2.38% vs. 0.69%, aOR: 3.12; 95% CI: 1.69–5.78), prematurity (9.06 vs. 4.90%, aOR: 3.31; 95% CI: 2.54–4.31), cesarean section (43.55% vs. 33.76%, aOR: 1.41; 95% CI: 1.17–1.71), and prolonged hospital stay (1.82% vs. 5.91%, aOR: 3.23; 95% CI: 2.16–4.83) were higher in those women who had nonobstetric surgery after adjusting for age and comorbidities.ConclusionsNonobstetric surgery during gestation were associated with a higher risk of spontaneous abortion, adverse delivery outcomes, cesarean section, and prolonged hospital stay.
Highlights
IntroductionNonobstetric surgeries, including those directly related to pregnancy (e.g., cerclage or ovarian cystectomy) and those which are un-related to pregnancy (e.g., appendectomy or surgery for bone fracture) [1], are performed in 0.75 to 2.0% of all pregnancies worldwide [2]
Nonobstetric surgeries, including those directly related to pregnancy and those which are un-related to pregnancy [1], are performed in 0.75 to 2.0% of all pregnancies worldwide [2]
After exclusion, we were left with 114,852 delivery and 3999 abortion cases in our study; and 462 (0.39%) of them had nonobstetric surgery under general or regional anesthesia during pregnancy
Summary
Nonobstetric surgeries, including those directly related to pregnancy (e.g., cerclage or ovarian cystectomy) and those which are un-related to pregnancy (e.g., appendectomy or surgery for bone fracture) [1], are performed in 0.75 to 2.0% of all pregnancies worldwide [2]. Few studies have reported information about abortion [12], fetal outcomes [13,14,15], and obstetric outcomes [13, 16] in women having nonobstetric surgery during pregnancy. A large scale British study analyzed the association of adverse obstetric outcomes in such patients [16]. No similar studies are available on this topic in the Asian population. We aimed to assess the risk of miscarriage and adverse pregnancy outcomes following nonobstetric surgery during gestation by using a nationwide population-based database in Taiwan. Whether nonobstetric surgery during gestation is associated with a higher risk of spontaneous abortion or adverse delivery outcomes is still unclear
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