What question did this study set out to answer?

Analyze maternal outcomes in women with ostomies undergoing vaginal and cesarean deliveries at a national level.

February 14, 2026Pregnancy0 citationsOpen Access

Maternal outcomes among ostomy patients undergoing vaginal and cesarean deliveries: A national analysis

SMSona MahrokhiUniversity of California, Los Angeles AVAmulya VadlakondaUniversity of California, Los Angeles TCTroy Coaston

Key Points

Analyze maternal outcomes in women with ostomies undergoing vaginal and cesarean deliveries at a national level.
Retrospective cohort study using National Readmissions Database from 2016 to 2022.
Identified adult hospitalizations for vaginal or cesarean delivery with ostomy diagnosis using ICD-10 codes.
Performed risk-adjusted analyses using entropy balancing and multivariable regression models.
Out of 13,292,764 deliveries, 926 involved women with ostomies, indicating a 1.5-fold increase from 2016 to 2022.
Ostomy was linked to higher odds of severe maternal morbidity (adjusted odds ratio 1.57).
Care at medium or high-volume emergency general surgery centers was associated with reduced odds of severe maternal morbidity.
Higher hospitalization costs were associated with ostomy, averaging an increase of $1.18k.
30-day readmission odds were higher for ostomy patients, with an adjusted odds ratio of 1.54.

Abstract

Abstract Background With the increasing prevalence of conditions requiring stoma creation in younger populations, a growing number of women with ostomies are considering pregnancy. However, limited data exist regarding maternal outcomes at the national level. Methods This retrospective cohort study analyzed the National Readmissions Database from 2016 to 2022. All adult hospitalizations involving vaginal or cesarean delivery were identified using International Classification of Diseases 10th Revision codes and stratified based on documentation of an ostomy diagnosis code during the index hospitalization. The primary outcome was severe maternal morbidity (SMM). Secondary outcomes included individual complication categories, in‐hospital mortality, and resource utilization. Risk‐adjusted analyses were performed using entropy balancing and multivariable regression models. Results Among 13, 292, 764 delivery hospitalizations, 926 (∼0. 01%) involved pregnant women with ostomies. The prevalence of ostomy during deliveries increased 1. 5‐fold during the 7‐year study period from 2016 to 2022, from 7. 1 to 10. 6 per 100, 000 deliveries overall, with specific increases observed for both cesarean (15. 3 to 19. 9 per 100, 000) and vaginal (3. 0 to 7. 5 per 100, 000) deliveries. After risk adjustment, ostomy was associated with increased odds of SMM (adjusted odds ratio AOR, 1. 57; 95% CI, 1. 04–2. 36). Treatment at medium (AOR, 0. 95; 95% CI, 0. 94–0. 97) and high‐volume emergency general surgery (EGS) centers (AOR, 0. 94; 95% CI, 0. 92–0. 96) was associated with reduced odds of SMM. Ostomy was linked with increased hospitalization costs by 1. 18k (95% CI, 473–1890), and tendency toward higher odds of 30‐day readmission (AOR, 1. 54; 95% CI, 0. 91–2. 60). Conclusion Maternal ostomy is associated with increased SMM and resource utilization during birthing hospitalizations. However, specialized care at medium and high‐volume EGS centers may reduce these risks. These findings highlight the need for specialized protocols for pregnant women with ostomies to optimize maternal outcomes.

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