INTRODUCTION: Data on sarcoidosis in pregnancy are sparse and limited to a few case reports and series. Our aim is to determine the prevalence of sarcoidosis at delivery and related maternal and newborn outcomes.
METHODS: Using the U.S. Healthcare Cost and Utilization Project–Nationwide Inpatient Sample from 2003 to 2010, we conducted a population-based retrospective cohort study to compare women with and without sarcoidosis at delivery. We calculated the prevalence of sarcoidosis in pregnancy and used logistic regression analyses to estimate the associated risks of maternal and neonatal outcomes.
RESULTS: There were 678 cases of sarcoidosis in 7,094,400 births over an 8-year period for an overall prevalence of 9.6 cases per 100,000 births. Compared with women in a control group, women with sarcoidosis were older, more likely to be African American, and to report being smokers. Women with sarcoidosis were more likely to have preeclampsia (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.18–2.22), eclampsia (OR 5.27, 95% CI 1.69–16.40), deep vein thrombosis (OR 4.92, 95% CI 1.58–15.33), pulmonary embolism (OR 6.68, 95% CI 3.99–11.21), and premature delivery (OR 1.73, 95% CI 1.40–2.15). There was also an increased risk of caesarean deliveries and postpartum hemorrhages. There were no cases of maternal death reported.
CONCLUSION: Sarcoidosis in pregnancy is a rare disease associated with an increased risk of adverse obstetric outcomes. Women with sarcoidosis can carry out successful pregnancies; however, they should be made aware of the higher risk of adverse events. Given the higher risk of venous thromboembolic events, consideration should be given to thromboprophylaxis in pregnancy.
Financial Disclosure: Vicky Hadid, MD, Valerie Patenaude, MSc, Lisa Oddy, MSc, and Haim Abenhaim, MD, MPH—These authors have no conflicts of interest to disclose relative to the contents of this presentation.
© 2014 by The American College of Obstetricians and Gynecologists.