>

030. Pregnancy in Spina Bifida Mothers: A comparative analysis of Peripartum Procedures and Complications

Authors: Bao Sciscent

Introduction:
Spina Bifida (SB) is caused by failure in neural tube closure that can present with lower extremity sensory deficits, paralysis, and hydrocephalus. Medical advances have allowed increased pregnancies among SB females, but management and pregnancy-associated complications have not been thoroughly investigated. The objective is to identify peripartum procedures and complications of women with and without SB.Methods: We used a multi-institutional, de-identified database (TriNetX) to gather information regarding pregnant SB females and the general population. We explored peripartum procedures and complications using corresponding ICD-10 and CPT codes within 1 year of pregnancy diagnosis.
Results:
3583 SB patients with deliveries were identified and compared to 2,715,259 non-SB females. Average age at pregnancy was 29.3 years for SB mothers and 28.3 years for non-SB mothers. At delivery, SB mothers were significantly more likely to undergo cesarean delivery (1.931; 95% CI 1.768-2.108) and less likely to receive neuraxial analgesia (0.683; 95% CI 0.599-0.783). SB females with delivery had higher rates of seizures (3.145; CI 2.576-3.838) and deep venous thrombosis (DVT) or pulmonary embolism (PE) (2.741; CI 2.192-3.428). Pre-eclampsia and hemorrhage rates were non-significant. SB females with hydrocephalus, type 1 Chiari malformation, and type 2 Chiari malformation compared to those without these conditions showed significantly higher rates of cesarean deliveries (15.28%, 20.07%,17.92% vs. 12.28%) and PE/DVT (6.02%, 3.40%, 2.13% vs. 1.64%), respectively. There were also higher rates of hemorrhage and seizures and decreased use of neuraxial analgesia, but the sample size was insufficient. However, rates of pre-eclampsia (10%, 13.27%,12.39% vs. 12.55%) were comparable across the cohorts.
Conclusion:
SB mothers were more likely to have a cesarean section and exhibit peripartum complications compared to those without SB.