Obstetric Outcomes of Pregnancy Complicated by Marfan Syndrome: A Retrospective Cohort Study [28D]

INTRODUCTION: Marfan Syndrome (MS) effects 1/3,300 individuals in the US and confers significant potential for morbidity in pregnancy. Cardiovascular complications, namely aortic dissection, have been the primary focus of previous investigations of pregnancy in women with MS. This study aims to elucidate MS-associated obstetric complications. METHODS: This retrospective cohort study examined singleton, non-anomalous pregnancies recorded by the California Birth Registry from 2006-2010. Of collected pregnancies, 61 were complicated by MS as identified and defined by the registry. The remaining 2,039,809 pregnancies comprised the control group. Simple rates of 17 obstetric complications were compared between groups. Chi squared tests and multivariate regression were used for statistical analysis, with p < 0.05 as the cutoff for significance. RESULTS: Pregnancies complicated by MS were significantly more likely to result in preterm delivery (16.4%, p=0.04), neonates small for gestational age (13.5%, p=0.027), and neonatal hypoglycemia (3.3%, p=0.022). Postpartum hemorrhage was also more likely though not significantly (6.6%, p=0.079). MS was associated with significantly decreased likelihood of gestational diabetes (0.0%, p=0.043). Intrauterine fetal demise, neonatal death, deep vein thrombosis, and uterine rupture were absent in this cohort. Maternal length of stay was not significantly longer in pregnancies with MS. CONCLUSION: Our results indicate MS is associated with increased likelihoods of several obstetric complications and decreased likelihood of gestational diabetes. These findings are consistent with existing literature, though an association with neonatal hypoglycemia has not been described. Several other complications were notably absent despite being reported previously. Our findings strengthen limited literature on obstetric outcomes in pregnancy complicated by MS.