Importance: More pregnant women have complex medical histories known to increase maternal morbidity and mortality. While the association between individual co-morbidities and complications has been studied, the joint effect of multiple pre-gestational diagnoses is unclear.
Objective: To determine the most common combinations of pre-gestational diagnoses and their potential synergistic effects on common pregnancy-related complications.
Design: This was a cross-sectional study of data from the 2016 Healthcare Cost and Utilization Project’s National Inpatient Sample database. A chi-squared analyses of combinations of pre-gestational diagnoses was performed to assess the relative risk of pregnancy-related complications.
Setting: Largest all payer hospital inpatient care database in the United States.
Participants: Inclusion criteria were: Diagnosis Related Groups assumed to be associated with delivery, and three or less ICD 10 codes with a prevalence greater than or equal to 0.5% or clinically important risk factors in Bateman’s co-morbidity index. Exclusion criteria included: Diagnosis Related Groups assumed not to be associated with delivery, uncommon diagnoses not defined a-priori, missing ICD 10 codes, or four or more ICD 10 codes.
Main outcome and measure: Most common combination of diagnoses and the relative risk of complications.
Enter diagnosis #1
Enter diagnosis #2
GDM: gestational diabetes
Note: some combinations of diagnoses were not studied together due to low prevalence (for example, there were very few patients with pre-gestational diabetes and no other diagnoses). If the combination was not able to be studied, the table will return blank results.