Pregnancy and stomas: a 9‐year retrospective series at a major metropolitan hospital in Brisbane Queensland

• Published in: ANZ journal of surgery Vol. 94; no. 9; pp. 1617 - 1621
• Main Authors: Kelly, Madeleine Louise, Fullerton, Alexandra, Cao, Amy Millicent Yesheng, Colbran, Rachel, Kimble, Rebecca, Clark, David A.
• Format: Journal Article
• Language: English
• Published: Melbourne John Wiley & Sons Australia, Ltd 01.09.2024; Blackwell Publishing Ltd
• Subjects: Birth weight; Births; Cesarean section; colorectal surgery; Demographics; Fertilization; general surgery; Gestational age; Hospitals; Low birth weight; Morbidity; Neonates; Ostomy; Patients; Postpartum; Postpartum period; Pregnancy; Pregnancy complications; stoma; general surgery; stoma; colorectal surgery; pregnancy
• ISSN: 1445-1433; 1445-2197; 1445-2197
• DOI: 10.1111/ans.19142

Background Over 42 000 Australians live with a stoma, and this number increases annually. Pregnancy in stoma patients is a rare but complex condition and there is limited published literature regarding surgical and obstetric complications in pregnant stoma patients. The aim of this paper was to review stoma outcomes, perinatal morbidity and mortality, and early postpartum period in pregnant stoma patients. Methods Data was retrospectively obtained on women of childbearing age, with a stoma, who had been pregnant and birthed in the last nine years at the Royal Brisbane and Women's Hospital between January 2014 to December 2022. Data recorded included patient demographics, type of stoma, indication for stoma, need for additional abdominal surgeries, method of conception, pregnancy complications, length of stay, neonatal outcomes and post pregnancy stomal complications. Results In total, there were 16 births from 13 mothers with stomas. Of 10 births to IBD patients, 40% experienced a serious stomal complication. Caesarean section (CS) rate was 90% for IBD and 83% for non‐IBD. In‐vitro fertilisation rates were 40% in IBD patients and 0% in non‐IBD patients. The average gestational age at delivery was 36 weeks in IBD and 35 weeks in non‐IBD patients. Neonates delivered to IBD mothers had a birth weight under 2500g in 40% of cases and in non IBD mothers at 33.3% (p = 0.62). Of the sixteen births there was five complications (31.25%) associated with the stoma either during pregnancy or during the sixty‐day postpartum period. Conclusion Pregnancy in stoma patients is a rare occurrence and appears to be associated with high rates of CS, preterm delivery, low birth weight and stomal complication. An original article reviewing outcomes of pregnant stomal patients over the past 9 years at RBWH. The paper analysed neonatal outcomes, complication rates and maternal outcomes.