Abstract 214P
Background
Our aim was to determine whether breast cancer survivors are at increased risk of obstetric and maternal complications at time of delivery.
Methods
The USA ‘National Inpatient Sample’ database was queried for hospitalizations associated with deliveries, between 2015 and 2018. The incidence of maternal and fetal complications was compared between women with, and without, a personal history of breast cancer.
Results
Of the 2,103,216 birth related admissions, 617 (0.03%) of the women were breast cancer survivors, with the proportion increasing over time (from 0.02% in 2015 to 0.04% in 2018). Of these, 50.5% were White, 19.9% Hispanic, 14% Black, 5.7% Asian/Pacific Islander, 5.1% other or unknown. Compared to the other ethnic groups, a smaller proportion of Hispanic origin were breast cancer survivors [OR 0.5, 95% confidence interval (CI) 0.39-0.65, p< 0.001]. Breast cancer survivors had a higher socioeconomic status (p <0.001) and were significantly older compared to other mothers (34 vs. 28 years, p<0.001). Additionally, they were more likely to suffer from preexisting chronic diseases including cardiopulmonary disease and diabetes mellitus, and had a higher incidence of multiple gestation (4.4% vs. 1.6%) [OR 2.7, 95% CI 1.9-4.0, p<0.001]. The incidence of acute adverse events at time of delivery including fetal distress, preterm labor, cesarean section and maternal infection was higher amongst the breast cancer survivors. On multivariate analysis age, ethnic group, comorbidities, multiple gestations, and a previous breast cancer diagnosis, but not cancer treatment were associated with an increased risk of an obstetric adverse event.
Conclusions
Breast cancer survivors are at increased risk of obstetric and maternal complications, the absolute numbers are low. Disparity due to race and socioeconomic status should be avoided. We advise that the care of all young patients with breast cancer should be discussed within a multidisciplinary team before any treatment decision making, including consultation about fertility and family planning. When pregnancy is desired or planned, appropriate screening and management of potential comorbidities is needed, and the pregnancy should be managed by a multidisciplinary team.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.