Gokulakrishnan Balasubramanian, MD1, Kevin Litzenberg, MD1, Alice Hinton, PhD1, Subhankar Chakraborty, MD1, Darwin L. Conwell, MD, MS1, Somashekar G. Krishna, MD, MPH2; 1The Ohio State University, Columbus, OH; 2The Ohio State University Wexner Medical Center, Columbus, OH
Introduction: Gastroparesis is a chronic condition characterized by delayed gastric emptying in the absence of mechanical obstruction. Pregnancy is often complicated by nausea and vomiting, possibly related to the neurohormonal dysregulation. There is a paucity of literature addressing the impact of gastroparesis on pregnancy outcomes. Hence, we sought to study the effect of gastroparesis on maternal and fetal outcomes during pregnancy. Methods: The National Readmission Database (NRD 2016-2017) was queried to capture all pregnancies using ICD-10 codes. Of this cohort, pregnancies complicated by gastroparesis were identified using ICD-10 code(K31.84), which was internally validated in our institution. Gastroparesis related outcomes (malnutrition, need for gastrostomy tube), and pregnancy-related outcomes (preeclampsia, miscarriages, preterm labor, etc.) were compared between pregnancies with and without gastroparesis. Propensity-score matched analysis using weighted regression models were used to compare the maternal and fetal outcomes between the two groups. Results: Among 1990 women with gastroparesis, there were higher frequency of hyperemesis gravidarum, anemia, malnutrition, preeclampsia/eclampsia, and intrauterine fetal death compared to those without gastroparesis on univariate analysis. Propensity weighed analysis showed that gastroparesis in pregnancy is associated with pre-eclampsia (7.87% vs 4.85%, OR: 1.67; 95% CI: [1.29, 2.17]), malnutrition (2.25% vs 0.63%, OR: 2.25; 95% CI: [1.21, 4.18]), higher 30-day readmission (22.75% vs 10.71%, OR: 2.46; 95% CI: [2.00, 3.02]) and longer hospital stay (5.18 vs 4.43 days, Coefficient: 0.75 ; 95% CI: [0.15, 1.36]), compared to non-gastroparesis group (Table 1). Discussion: Gastroparesis adversely impacts maternal outcome during pregnancy, often complicated by preeclampsia, hyperemesis gravidarum, malnutrition, and anemia. Targeted management of gastroparesis, including nutritional support, glycemic control, appropriate management of the symptoms and its complications would be of paramount importance in reducing the adverse outcomes during pregnancy.
Table 1: Analysis of outcomes in the propensity weighted sample.
Disclosures: Gokulakrishnan Balasubramanian indicated no relevant financial relationships. Kevin Litzenberg 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. Somashekar Krishna indicated no relevant financial relationships.