Obstetric management and pregnancy outcomes in pregnant women with kyphoscoliosis: a 15-year single-center retrospective cohort study.

BACKGROUND

Kyphoscoliosis is a complex spinal deformity that may pose significant obstetric, anesthetic, and neonatal challenges during pregnancy. The aim of this study was to systematically evaluate obstetric management strategies and pregnancy outcomes in women with kyphoscoliosis based on a 15-year clinical experience.

METHODS

This retrospective study included adult pregnant women with clinically and radiologically confirmed kyphoscoliosis who delivered at the Department of Obstetrics and Gynecology, Ondokuz Mayıs University Faculty of Medicine, a tertiary referral center, between 2010 and 2025. Maternal characteristics, deformity-related parameters (including Cobb angle and prior spinal surgery), obstetric outcomes, anesthetic management, and neonatal outcomes were analyzed. Deformity severity was categorized based on Cobb angle as mild, moderate, or severe. Given the limited sample size, analyses were primarily descriptive, with comparative statistics applied where appropriate.

RESULTS

A total of 33 pregnancies were included. All cases were associated with adolescent idiopathic scoliosis, with a mean Cobb angle of 24.9 ± 12.2° and 42% of patients had a history of spinal surgery prior to pregnancy. The mean gestational age at delivery was 36 weeks. Cesarean section was performed in 94% of cases, and general anesthesia was predominantly required. Obstetric complications included fetal growth restriction, hypertensive disorders, gestational diabetes, and amniotic fluid abnormalities. Maternal complications were rare; with ileus in two cases and intensive care unit admission required in three patients. Neonatal intensive care admission was observed, and three neonatal deaths occurred, primarily related to underlying neonatal conditions. Subgroup analyses suggested higher maternal complication and intensive care admission rates among patients with severe deformity.

CONCLUSIONS

Kyphoscoliosis in pregnancy may be associated with increased obstetric and neonatal risks, even in cases with moderate deformity. Management in tertiary care centers with multidisciplinary planning appears essential.