Bleeding Events and Obstetric Complications of Pregnancy in Hospitalized Patients with Hemophilia: Results from Nationwide Inpatient Sample Database 2003-2011

Study examines Bleeding and Obstetric Complications of Pregnancy in Hospitalized Women with Congenital Hemophilia

ASH 2017 (Atlanta, GA, December 9-12): This study examined pregnant women with congenital hemophilia A or B and compared their outcomes and pregnancy related complications with pregnant women who did not have hemophilia.

Using data from the Nationwide Inpatient Sample (NIS) database of Healthcare Cost and Utilization Project (AHRQ), researchers identified the number of child birth related (obstetric) hospitalizations, deliveries and caesarean (“C-section”) deliveries in women ages 18-50. They then compared pregnancy related complications for women with and without Hemophilia.  There were 2415 obstetric hospitalizations for women with Hemophilia A or B.

Women with hemophilia had a significantly higher rates of caesarian section (37.5% vs 28%), intrauterine growth retardation (3.2% vs 1.8%), preterm deliveries (7.9% vs 6.6%), bleeding/hemorrhage that occurred before birth (4.5% vs 2%), bleeding/hemorrhage that occurred after delivery (5% vs 2.6%) and transfusion rate (4.2% vs 1.1%) compared to women without congenital hemophilia.  The incidence of premature rupture of membranes in the women with hemophilia was less as compared to the women without hemophilia. There were no deaths in unborn offspring or the pregnant mothers with hemophilia.

The overall risk of cesarean section, intrauterine growth retardation, and preterm deliveries, risk of transfusion and bleeding/hemorrhage was higher in pregnant women who have hemophilia. This study helps to understand the extent of these complications so that they could be managed optimally before birth. Future studies are needed to examine these findings in relation to severity of disease, medications used and the presence of other comorbidities.