The impact of prenatally diagnosed Klinefelter Syndrome on obstetric and neonatal outcomes

• Published in: European journal of obstetrics & gynecology and reproductive biology 2016-08, Vol.203, p.173-176
• Main Authors: Dotters-katz, Sarah K, Humphrey, Whitney M, Senz, Kayli L, Lee, Vanessa R, Shaffer, Brian L, Caughey, Aaron B
• Format: Article
• Language: English
• Subjects: 47; XXY; Adult; Cesarean Section - adverse effects; Cesarean Section - economics; Cohort Studies; Costs and Cost Analysis; Electronic Health Records; Female; Fetal Death - etiology; Genetic Testing - economics; Hospital Costs; Humans; Infant, Newborn; Infant, Newborn, Diseases - economics; Infant, Newborn, Diseases - etiology; Infant, Newborn, Diseases - therapy; International Classification of Diseases; Klinefelter Syndrome; Klinefelter Syndrome - diagnosis; Klinefelter Syndrome - economics; Klinefelter Syndrome - physiopathology; Klinefelter Syndrome - therapy; Male; Maternal Age; neonatal outcomes; Obstetrics and Gynecology; Perinatal Death - etiology; Pregnancy; Pregnancy Complications - economics; Pregnancy Complications - etiology; Pregnancy Complications - therapy; Pregnancy Outcome; Prenatal Diagnosis - economics; Retrospective Studies
• ISSN: 0301-2115; 1872-7654
• DOI: 10.1016/j.ejogrb.2016.05.006

Abstract Objective The objective of this study was to examine the obstetric and neonatal outcomes as well as the as the associated hospital costs for pregnancies complicated by prenatally diagnosed Klinefelter Syndrome, 47,XXY. Study design We conducted a retrospective cohort study of all of the singleton deliveries in California from 2005 to 2008 using vital statistics and ICD-9 data, specifically identifying cases of fetal Klinefelter Syndrome. Specifically, we were interested in the outcomes of preterm delivery, preeclampsia, intrauterine fetal demise, cesarean delivery, neonatal death, respiratory distress syndrome (RDS), small for gestational age, large for gestational age, neonatal death, and infant death. Bivariate and multivariate analyses were used to compare pregnancies and neonates affected by prenatally diagnosed Klinefelter Syndrome to those that were not affected with 47,XXY. Results There were 2,029,000 deliveries in the cohort, including 52 women with prenatally diagnosed 47,XXY. Advanced maternal age, completion of 12th grade, and private insurance were all associated with a prenatal diagnosis of Klinefelter Syndrome. Compared to unaffected deliveries, pregnancies complicated by prenatally diagnosed Klinefelter Syndrome had higher rates of preterm delivery (23.1% vs 9.9%, p = 0.0004), cesarean delivery (50.0% vs 30.2%, p = 0.004), and RDS (9.6% vs 1.2%, p =