Maternal Outcomes and Resource Utilization in Pregnancy-Related Hospitalizations Among Patients With Irritable Bowel Syndrome: A Nationwide Inpatient Analysis, 2020-2022

TL;DR

This study found that IBS during pregnancy is linked to more complex hospital stays and higher costs, but not major maternal complications.

Contribution

The study provides new nationwide data on IBS in pregnancy-related hospitalizations and its associations with maternal outcomes.

Findings

IBS was associated with longer hospital stays and higher charges.

IBS was linked to placental complications and postpartum infections.

IBS was not associated with major maternal complications or mortality.

Abstract

Background

Irritable bowel syndrome (IBS) is common among women of reproductive age, yet its implications for pregnancy-related hospitalizations and maternal outcomes in contemporary inpatient settings remain incompletely characterized. Accordingly, this study aimed to address this gap.

Methods

We performed a retrospective, cross-sectional analysis of delivery-related hospitalizations from 2020 to 2022 using the Nationwide Inpatient Sample (NIS). IBS was identified using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) diagnosis codes documented during the delivery hospitalization. Survey-weighted analyses were used to generate nationally representative estimates. Multivariable regression models, adjusted for demographic factors, obstetric characteristics, medical comorbidities, psychiatric conditions, and substance use, were used to evaluate the associations between IBS and maternal outcomes, length of stay, and total hospital charges. Sensitivity analyses examined placenta-specific outcomes and postpartum infections using more granular outcome definitions.

Results

Among 2,086,607 weighted pregnancy-related hospitalizations, 4,889 (0.23%) had a documented diagnosis of IBS. Patients with IBS were older and had a higher burden of psychiatric, metabolic, and substance-related comorbidities. After multivariable adjustment, IBS was independently associated with prolonged length of stay (adjusted odds ratio (aOR): 1.29, 95% confidence interval (CI): 1.13-1.48), higher hospital charges (adjusted mean increase: $1,656, 95% CI: $769-$2,544), placental complications (aOR: 1.23, 95% CI: 1.08-1.40), and postpartum infection (aOR: 1.41, 95% CI: 1.00-1.98). IBS was not associated with major maternal complications or mortality. Sensitivity analyses demonstrated outcome specificity.

Conclusions

In this contemporary nationwide inpatient analysis, IBS was infrequently documented during pregnancy-related hospitalizations but was associated with an increased comorbidity burden, resource utilization, and select obstetric complications. These findings suggest that IBS in pregnancy functions as a marker of obstetric complexity rather than a strong independent risk factor for most major maternal complications.