Kevin Litzenberg, MD1, Somashekar G. Krishna, MD, MPH2, Alice Hinton, PhD1, Subhankar Chakraborty, MD1, Darwin L. Conwell, MD, MS1, Gokulakrishnan Balasubramanian, MD1; 1The Ohio State University, Columbus, OH; 2The Ohio State University Wexner Medical Center, Columbus, OH
Introduction: Gastroparesis is a chronic gastrointestinal condition that contributes to significant morbidity and frequent hospitalization. Pregnancy is a diabetogenic state that can be complicated by gastroparesis. The impact of diabetic and idiopathic gastroparesis is largely unknown in pregnancy. Hence, we sought to evaluate and compare the maternal and fetal outcomes in pregnant patients with diabetic and idiopathic gastroparesis. Methods: The National Readmission Database (NRD 2016-2017) was queried for patients with a primary or secondary hospital discharge diagnosis of gastroparesis (International Classification of Disease, Tenth Revision Code K31.84) during pregnancy. Propensity weighted regression models accounting for survey structure were used to compare the maternal and fetal outcomes in diabetic and idiopathic gastroparesis. Results: Of 1990 pregnant patients with gastroparesis 760 (38.2%) patients had diabetes, while the remaining 1230 (61.8%) were classified as idiopathic. After propensity weighting was applied, there were significant differences in multiple outcomes-related measures between pregnant patients with diabetic and idiopathic gastroparesis (Table 1). Women with diabetic gastroparesis were significantly more likely to have pregnancies complicated by pre-eclampsia and eclampsia (OR 3.39, 95% CI [1.75, 6.58]) as well as preterm labor and delivery (OR 2.57 95% CI [1.32, 5.02]); additionally, lengths of stay (LOS) for admissions of women with diabetic gastroparesis were significantly longer than those with non-diabetic gastroparesis (6.32 versus 4.72 days, p=0.045). Discussion: Diabetic gastroparesis impacts pregnant women with a higher risk of adverse outcomes even than idiopathic gastroparesis. Accordingly, focused management of glycemic control and nutritional supplementation would likely alleviate the maternal and fetal adverse outcomes secondary to diabetic gastroparesis during pregnancy. Great care is required in managing pregnant patients with diabetic gastroparesis given this propensity for poor outcomes.
Analysis of outcomes for pregnancies complicated by diabetic vs idiopathic gastroparesis in a propensity weighted sample.
Disclosures: Kevin Litzenberg indicated no relevant financial relationships. Somashekar Krishna indicated no relevant financial relationships. Alice Hinton indicated no relevant financial relationships. Subhankar Chakraborty indicated no relevant financial relationships. Darwin Conwell indicated no relevant financial relationships. Gokulakrishnan Balasubramanian indicated no relevant financial relationships.