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Oral Concurrent Session 9 - Medical Complications

Oral Concurrent Sessions

Oral Concurrent Session 9 - Medical Complications

(98) Risk of severe maternal morbidity among pregnant people with colorectal cancer using a population database

Saturday, February 1, 2025
8:45 AM – 9:00 AM  
Location: Aurora Ballroom CD, Lobby Level
Objective: Colorectal cancer is among the top three leading causes of new cancer diagnosis as well as cancer death for females in the United States. The purpose of this study was to determine the odds of severe maternal morbidity (SMM) in patients with colorectal cancer in pregnancy using TriNetX, a research network containing real-time data from 93 health care organizations and > 131 million patients.

Study Design:
This retrospective cohort study queried TriNetX from inception to 8/2024 for subjects 12-55 years with a pregnancy diagnosis. Two cohorts were derived: (1) individuals with an active diagnosis of colorectal cancer 1 year prior to, or up to 1 month after, first instance of pregnancy and (2) those without a history of any cancer type in pregnancy. Cohorts were propensity score matched 1:1 by demographics and comorbidities by TriNetX built-in analysis tools. SMM was defined as CDC’s 21 indicators and corresponding ICD-10 codes. The primary outcome was odds ratio (OR) between cohorts of composite SMM occurring up to 1 year after first instance of pregnancy. Secondary outcomes were odds of individual indicators of SMM. All statistical analyses were conducted in the TriNetX platform.



Results:
After propensity score matching, 7570 individuals were included in each cohort (Table). Subjects with colorectal cancer in pregnancy had significantly higher odds of composite SMM with OR 4.43 (95% confidence interval (CI) 3.77-5.22, p< 0.001) compared to those without cancer history in pregnancy. The odds of disseminated intravascular coagulation (DIC) were highest (OR 4.29, 95% CI 3.38-5.43), followed by acute respiratory distress syndrome (ARDS) (OR 3.73, 95% CI 3.12-4.46) and hysterectomy (OR 3.03, 95% CI 1.66-5.56).



Conclusion: Patients with colorectal cancer in pregnancy have more than four-fold increased odds of composite SMM compared to those without cancer history, with considerably higher risk of DIC, ARDS and hysterectomy.