Comorbidity and hospital procedures in pregnancies with congenital anomalies: population-based study

Background

Maternal comorbidities and their relationship with fetal outcomes are a key public health concern. Although the aetiology of many congenital anomalies (CA) is unknown, maternal characteristics may influence their occurrence and the need for hospitalization.

Aim

to describe comorbidities and procedures recorded in hospitalization records of pregnant women whose children had CA

Methods

Cross-sectional study was performed in pregnant women, residents in Valencian Region (VR, Spain), who had children between 2007-2022, live or stillbirths and diagnosed with CA, and who had at least one hospitalization during pregnancy. Pregnant women were identified from the CA population-based registry of VR, and their hospitalizations from the Hospital Discharge Database between 2006-2023. Descriptive analysis of hospitalisations characteristics was performed overall and by trimester of pregnancy

Results

13711 hospitalizations were recorded among 10884 pregnant women, who had 10974 children with CA. The median number of diagnoses was 5, 95.5% had any diagnosis included in a specific chapter of pregnancy. In first trimester, 59.5% did not have diagnoses in this specific chapter and the main diagnosis was related to assisted reproductive fertility. Diabetes (8.7%) and hypertension (5.5%) were the most frequent comorbidities. The median number of procedures per hospitalization was 3; 87.5% were obstetric and 32.2% cesarean sections. Main diagnosis and procedure in hospitalizations that required ICU were preeclampsia (44.4%) and cesarean (87.7%). Pregnant women group with children with congenital heart defects had more surgical procedure proportion (than other CA) with statistical differences

Conclusions

Early diagnoses related to fertility problems highlight the need for enhanced monitoring from the first trimester. Integrating population-based and hospital data would strengthen surveillance and improve understanding of factors associated with CA and maternal hospitalization

Key messages

• Pregnancies affected by congenital anomalies show a high burden of maternal comorbidities and procedures, with hospitalizations largely obstetric and varying by trimester.

• Integrating population-based registries with hospital data strengthens public health surveillance and supports earlier identification of maternal risks and improved care planning.