Route of Delivery Does Not Impact Postnatal Surgical Morbidity in Pregnancies Affected by Fetal Achondroplasia

Authors

Bobby K Brar
Michael B Bober
Ethan Gough
S Shahrukh Hashmi
Jacqueline T Hecht
Lorena Dujmusic
Mary E Little
Peggy Modaff
Richard M Pauli
David F Rodriguez-Buritica
Maria E Serna
Cory Smid
Janet M Legare
Julie E Hoover-Fong

Language

English

Publication Date

7-1-2023

Journal

Genetics in Medicine

DOI

10.1016/j.gim.2023.100845

PMID

37061874

PMCID

PMC12131108

PubMedCentral® Posted Date

6-3-2025

PubMedCentral® Full Text Version

Author MSS

Abstract

Purpose: Pregnancies affected by maternal or fetal achondroplasia present unique challenges. The optimal route of delivery in fetuses with achondroplasia has not been established. Our objective was to determine whether the route of delivery affects postnatal achondroplasia-related surgical burden.

Methods: We conducted a secondary analysis of Achondroplasia Natural History Study (CLARITY), which is a multicenter natural history cohort study of patients with achondroplasia. Achondroplasia-related surgical morbidity, which we defined as the need for one or more postnatal achondroplasia-related surgeries, was assessed in relation to the route of delivery and whether the mother also had achondroplasia. Rate of each individual surgery type (otolaryngology, brain, foramen magnum, spine, and extremity) was also assessed in relation to the route of delivery.

Results: Eight hundred fifty-seven patients with achondroplasia with known route of delivery and known maternal stature were included. Three hundred sixty (42%) patients were delivered vaginally, and 497 (58%) patients were delivered by a cesarean delivery. There was no difference in the odds of requiring any postnatal achondroplasia-related surgery in those with achondroplasia who were delivered vaginally compared with those delivered by cesarean birth (odds ratio 0.95, 95% CI = 0.68-1.34, P = .80). No difference was present in the odds of requiring any postnatal achondroplasia-related surgery when route of delivery was compared for fetuses born to 761 average stature mothers (odds ratio 1.05, 95% CI = 0.74-1.51, P = .78). There was also no difference in the odds of requiring each of the individual achondroplasia-related surgeries by route of delivery, including cervicomedullary decompression.

Conclusion: Our study suggests that it is reasonable for average stature patients carrying a fetus with achondroplasia to undergo a trial of labor in the absence of routine obstetric contraindications.

Keywords

Pregnancy, Female, Humans, Cohort Studies, Cesarean Section, Achondroplasia, Fetus, Morbidity, Retrospective Studies, Achondroplasia, Cesarean section, Prenatal genetics, Route of delivery, Vaginal delivery

Published Open-Access

yes

Recommended Citation

Brar, Bobby K; Bober, Michael B; Gough, Ethan; et al., "Route of Delivery Does Not Impact Postnatal Surgical Morbidity in Pregnancies Affected by Fetal Achondroplasia" (2023). Faculty, Staff and Student Publications. 6469.
https://digitalcommons.library.tmc.edu/uthgsbs_docs/6469