S2942 Cohort Analysis of Prenatal Maternal Factors on Ileus in Newborns

Introduction: Evidence has linked prenatal factors and maternal comorbidities to the development of ileus in newborns. These factors include maternal hypertension and diabetes, prolonged administration of tocolytics, preterm rupture of membranes and prematurity. This study aims to use a population-based cohort study to analyze these associations and identify those newborns that are at risk of developing ileus based on prenatal factors to allow for early intervention and morbidity reduction. Methods: A retrospective population-based cohort study was conducted utilizing the Texas Inpatient Public Use Data File (TIPUDF) from 2016 to 2023. Newborns were identified using the type of admission column of the TIPUDF. The primary exposure was a diagnosis of ileus identified using International Classification of Diseases, Tenth Revisions, Clinical Modification (ICD-10-CM) code P761 selected from Clinical Classification Software Refined (CCSR) category PNL012: Neonatal digestive and feeding disorders. Outcome variables were selected from CCSR category PNL010: Newborn affected by maternal conditions or complications of delivery. Continuous variables are summarized as mean and standard deviation (SD); categorical variables are summarized as counts and percentages. Fisher’s test and the t-test were applied to test differences across groups and the standardized mean difference (SMD) was used as an effect size. Results: Of the 2,906,295 newborns recorded in the TIPUDF from 2016-2023, 1,308 had a diagnosis of ileus. Newborns with ileus were more frequently male (56.0% vs 51.0%, SMD = 0.1003, P = 0.0003). Compared to newborns without ileus, those with ileus were associated with abnormal placenta architecture (0.2% vs 2.4%, SMD = 0.1950, P < 0.0001) which includes placenta previa, placenta separation and hemorrhage, and morphological/functional placental abnormalities as well as premature rupture of membranes (0.6% vs 3.4%, SMD = 0.2021, P < 0.0001). Newborns with ileus were also more frequently affected by maternal hypertension (0.5% vs 2.4%, SMD = 0.1630, P < 0.0001). Conclusion: Newborns with ileus had higher incidences of placental abnormalities (placenta previa, placenta separation and hemorrhage, morphological/functional abnormalities), premature rupture of membranes, and maternal hypertension when compared with newborns without ileus. These are key identifiers as newborns with undetected intestinal obstruction can deteriorate rapidly.