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Racial and Ethnic Disparities in Adverse Pregnancy Outcomes Among Women with Early Onset Cancer in the United States
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Department of Public Health, Julia Jones Matthews School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, Yale University, New Haven, CT 06520, USA
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Radiation Oncology Clinic, University Medical Center Cancer Center, Lubbock, TX 79430, USA
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Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA
*
Author to whom correspondence should be addressed.
Cancers 2026, 18(7), 1081; https://doi.org/10.3390/cancers18071081
Submission received: 18 February 2026
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Revised: 21 March 2026
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Accepted: 24 March 2026
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Published: 26 March 2026
(This article belongs to the Special Issue Global Perspectives on the Epidemiology and Management of Early-Onset Cancers)
Simple Summary
Despite well-established racial and ethnic disparities in cancer outcomes, little is known about the extent to which race/ethnicity influences adverse pregnancy outcomes among women with early onset cancer. Using data of 17.6 million singleton pregnancy-related hospitalizations among female adults aged 18 to 49 years from the National Inpatient Sample (2000–2022), we observed that the prevalence of births among women with cancer increased by more than 225%. Furthermore, racial and ethnic minority women had a higher risk for adverse pregnancy outcomes compared to non-Hispanic White women with cancer. The findings of the current study hold significant clinical importance as they inform efforts to achieve maternal health equity in the United States.
Abstract
Background: Despite well-established racial/ethnic disparities in cancer outcomes, little is known about the extent to which race/ethnicity influences adverse pregnancy outcomes (APOs) among women with early onset cancer. We evaluated racial/ethnic disparity in the occurrence of cancer during pregnancy and APOs among women with cancer in the United States. Methods: Data consisted of 17.6 million singleton deliveries among females aged 18–49 years from the National Inpatient Sample. Logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). Results: From 2000 to 2022, the prevalence of births among women with cancer increased more than 225%, from 120.4 to 391.8 per 100,000. After accounting for sociodemographic and behavioral/lifestyle factors and comorbidity index among women with cancer (n = 49,824, mean age = 33.4 years), non-Hispanic Black women had the highest odds for hypertensive disorders of pregnancy (OR = 1.67, CI: 1.54–1.82), preterm birth (OR = 1.44, CI: 1.26–1.64) and fetal death (OR = 3.04, CI: 1.99–4.63). Asian or Pacific Islander and Native American women had the highest odds for gestational diabetes (OR = 2.48, CI: 2.17–2.85) and fetal growth restriction (OR = 1.92, CI: 1.00–3.69), respectively. Among racial/ethnic minority women, the odds for maternal mortality and several APOs were significantly higher among those with cancer than those without cancer, with the odds for APOs being highest for breast cancer (OR = 1.39, CI: 1.23–1.56). Conclusions: This large population-based study showed significant racial and ethnic disparities in APOs among women with a concurrent cancer diagnosis at delivery. Targeted management of APO risk factors during pregnancy among racial/ethnic minority populations with cancer may help reduce adverse maternal and neonatal outcomes.
Keywords:
adverse pregnancy outcomes; race; cancer; ethnicity; early onset cancer; epidemiology
