Abstract 1214: Higher risk of adverse pregnancy outcomes among racial and ethnic minority women with cancer in the United States

BACKGROUND: Current evidence suggests that women with cancer often experience more obstetric complications compared to women without cancer. Despite well-established racial and ethnic disparities in cancer diagnosis, treatment, and comorbidities, little is known about extent to which race/ethnicity influence adverse pregnancy outcomes (APOs) in women with cancer. We evaluated racial and ethnic disparity in the occurrence of APOs among cancer patients in the United States. METHODS: Data consisted of 16.5 million deliveries among females aged 18 to 49 years from the National Inpatient Sample. Logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for the associations between race/ethnicity with hypertensive disorders of pregnancy, gestational diabetes, fetal growth restriction, preterm birth, maternal mortality and neonatal mortality among women with cancer. RESULTS: From 2001 to 2021, the prevalence of births among individuals with cancer increased by about 200%, from 135.3 to 396.2 per 100,000. Within each race and ethnicity, the odds of APOs tend to be significantly higher in most cases among women with cancer compared to those without cancer. After accounting for socio-demographics, behavioral/lifestyle factors and comorbidity index among women with cancer (n= 47,450, mean age=28.4 years), the occurrence of APOs tended to be higher among racial/ethnic minorities compared to non-Hispanic White women. For instance, non-Hispanic Black women had the highest odds for hypertensive disorders of pregnancy (OR=1.67, CI:1.53-1.82), fetal growth restriction (OR=1.61, CI:1.34-1.94), preterm birth (OR=1.36, CI:1.19-1.55) and fetal death (OR=2.75, CI: 1.78-4.27). Asian or Pacific Islander women had the highest odds for gestational diabetes (OR=2.37, CI: 2.05-2.74) while women of other/multiple races had the highest odds for maternal mortality (OR=1.72, CI: 1.08-2.75). With regard to type of cancer, compared to non-Hispanic White women, the risk of any APOs among racial/ethnic minority women were as follows: breast (OR= 1.32, CI:1.17-1.49), cervical (OR= 1.20, CI: 1.003-1.44), hematologic (OR=1.30, CI: 1.16-1.45), melanoma (OR= 1.05, CI: 0.80-1.39), ovarian (OR= 1.13, CI: 0.90-1.40), thyroid (OR= 1.34, CI: 1.19-1.50), uterine (OR= 1.65, CI: 1.03-2.63) and all other cancers (OR=1.19, CI: 1.07-1.32). CONCLUSIONS: Findings from this large population-based study showed significant racial and ethnic disparities in APOs and serious neonatal outcomes among women with a concurrent cancer diagnosis at delivery. Targeted management of APOs risk factors during pregnancy among racial/ethnic minority populations with cancer may help reduce adverse maternal and neonatal outcomes. Citation Format: Duke Appiah, Julie Sang, Eric K. Broni, Zheng Shi, Catherine Kim. Higher risk of adverse pregnancy outcomes among racial and ethnic minority women with cancer in the United States [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 1214.