Study Finds ‘Significant’ Racial and Ethnic Disparities in Pregnancy Outcomes Among Women With Cancer

Women with cancer among racial and ethnic minority groups in the United States have a higher risk of adverse pregnancy outcomes (APOs) compared with non-Hispanic White women, according to a study presented at the 2025 American Association for Cancer Research Annual Meeting.

After collecting data from 16.5 million childbirth deliveries among females aged 18 to 49 years from the National Inpatient Sample, the research team led by Duke Appiah, PhD, MPH, of the Texas Tech University Health Sciences Center, used logistic regression models to estimate the odds ratios (OR) and 95% confidence intervals (CI) for associations between race and ethnicity with hypertensive disorders of pregnancy, gestational diabetes, fetal growth restriction, preterm birth, maternal mortality, and neonatal mortality among 47,450 women with cancer. They also accounted for comorbidity index, sociodemographic, behavioral, and lifestyle factors.

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), while Asian or Pacific Islander women had the highest odds for gestational diabetes (OR=2.37; CI: 2.05-2.74). Multiracial women or women of other races had the highest odds for maternal mortality (OR=1.72; CI: 1.08-2.75).

“The care of a pregnant patient with a concurrent cancer diagnosis is especially complex in and of itself and requires careful planning and coordination between the obstetrician and the oncologist to ensure optimal outcomes for both the patient and the baby,” Bhavana Bhatnagar, DO, Director of Hematology and Medical Oncology at the West Virginia University Cancer Institute at Wheeling Hospital, told Blood Cancers Today. “I suspect that racial and ethnic disparities in this particular patient population are related to a number of factors related to the nature of the underlying cancer diagnosis and the treatment being pursued, as well as the other medical conditions that the patient has.”

Dr. Bhatnagar explained that some racial and ethnic groups are more predisposed to certain comorbidities, such as diabetes and hypertension, which may contribute to worse pregnancy outcomes if they are also diagnosed with cancer.

The study further broke down the risk of APOs among women of racial and ethnic minority groups compared to non-Hispanic White women by cancer type, including breast cancer (OR=1.32; CI:1.17-1.49), cervical cancer (OR=1.20; CI: 1.003-1.44), hematologic malignancies (OR=1.30; CI: 1.16-1.45), melanoma (OR=1.05; CI: 0.80-1.39), ovarian cancer (OR=1.13; CI: 0.90-1.40), thyroid cancer (OR=1.34; CI: 1.19-1.50), uterine cancer (OR=1.65; CI: 1.03-2.63), and other cancers (OR=1.19; CI: 1.07-1.32).

“Some of the more aggressive hematologic malignancies like acute leukemia and lymphomas can present major challenges for pregnant patients, since they require urgent therapy and cannot wait until after their pregnancy,” Dr. Bhatnagar told Blood Cancers Today. “The considerable care needs of patients with these types of blood cancers, coupled with pregnancy, makes it all the more necessary for them to receive their care at a center with the necessary resources and clinical expertise to properly manage them and address their needs.”

Reference

2025 American Association for Cancer Research Annual Meeting. Abstract No. 1214.