Risk Factors for Major Pregnancy Complications in Female Cardiothoracic Surgeons

Abstract

Objective: To describe the incidence of and risk factors for pregnancy complications in female cardiothoracic surgeons compared with women of similar sociodemographic profiles.

Background: Female cardiothoracic surgeons often postpone childbearing, but little is known about their pregnancy outcomes.

Methods: In 2023, a self-administered survey was distributed to US cardiothoracic surgeons/trainees. Surgeons with ≥1 live birth were queried on maternal work hours during pregnancy and major antenatal pregnancy complications. Male surgeons answered on behalf of non-surgeon childbearing partners (female non-surgeons).

Results: The study included 255 surgeons (63.53% male; 36.47% female). Compared with female surgeons, male surgeons more often had partners who were not employed outside the home (25.64% vs 13.33%, P <0.001). Female surgeons were older than female non-surgeons at first live birth (34.49±4.41 vs 31.45±4.16, P <0.001), more often worked >60 h/wk during pregnancy (70.33% vs 14.08%, P <0.001), and more often had pregnancy complications (45.16% vs 27.16%, P =0.003; operating room (OR): 1.78, 95% CI: 1.01-3.13). Among female surgeons, 18.28% reduced work hours during pregnancy. During their third trimester, 54.84% worked >6 overnight calls/mo, and 72.04% operated >12 h/wk. Age ≥35 years (OR: 3.28, 95% CI: 1.27-8.45) and operating >12 h/wk during the third trimester (OR: 3.72, 95% CI: 1.04-13.30) were associated with pregnancy complications.

Conclusions: Female cardiothoracic surgeons are more likely to experience major pregnancy complications than non-surgeon partners of their male peers. Long operative hours during pregnancy and older maternal age are significant risk factors for pregnancy complications. To advance gender equity, policies to protect maternal-fetal health and facilitate childbearing during training and early career are needed.