Kelly Victoria M, Nelson Lorene M, Chakravarty Eliza F
Department of Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA.
Neurology. 2009 Dec 1;73(22):1831-6. doi: 10.1212/WNL.0b013e3181c3f27d. Epub 2009 Nov 18.
To estimate the national occurrence of pregnancies in women with multiple sclerosis (MS) and epilepsy and to compare these pregnancy outcomes cross-sectionally with those in women with pregestational diabetes mellitus (DM) and the general obstetric population.
We studied the 2003-2006 Nationwide Inpatient Sample, of the Healthcare Cost and Utilization Project, to estimate the number of deliveries in women with MS, epilepsy, DM, and the general obstetric population. Pregnancy outcomes included length of hospital stay, hypertensive disorders including preeclampsia (HTN), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and cesarean delivery. Multivariable regression analyses used maternal age and race/ethnicity as covariates.
Of an estimated 18.8 million deliveries, 10,055 occurred in women with MS, 4,730 with epilepsy, and 187,239 with DM. MS was associated with mildly increased odds of antenatal hospitalization (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.5), IUGR (OR 1.7, 95% CI 1.2-2.4), and cesarean delivery (OR 1.3, 95% CI 1.1-1.4). Similarly, epilepsy was associated with increased rates of antenatal hospitalization (OR 3.0, 95% CI 2.6-3.5), IUGR (OR 1.9, 95% CI 1.2-3.3), and cesarean delivery (OR 1.5, 95% CI 1.3-1.9). HTN and PROM were not increased in either group. DM was associated with an increased risk of all adverse outcomes. Length of stay was modestly increased in all groups compared with controls.
In this large national database study of pregnancy outcomes in women with multiple sclerosis and epilepsy, rates of intrauterine growth restriction and cesarean delivery were only marginally higher than the general obstetric population without increases in other adverse outcomes.
评估患有多发性硬化症（MS）和癫痫的女性的全国妊娠发生率，并将这些妊娠结局与妊娠前糖尿病（DM）女性及普通产科人群的妊娠结局进行横断面比较。
我们研究了医疗成本与利用项目2003 - 2006年全国住院患者样本，以估计患有MS、癫痫、DM的女性以及普通产科人群的分娩数量。妊娠结局包括住院时间、高血压疾病（包括先兆子痫，HTN）、胎膜早破（PROM）、胎儿宫内生长受限（IUGR）和剖宫产。多变量回归分析将产妇年龄和种族/民族作为协变量。
在估计的1880万例分娩中，10055例发生在患有MS的女性中，4730例发生在患有癫痫的女性中，187239例发生在患有DM的女性中。MS与产前住院几率轻度增加相关（优势比[OR] 1.3，95%置信区间[CI] 1.2 - 1.5）、IUGR（OR 1.7，95% CI 1.2 - 2.4）和剖宫产（OR 1.3，95% CI 1.1 - 1.4）。同样，癫痫与产前住院率增加相关（OR 3.0，95% CI 2.6 - 3.5）、IUGR（OR 1.9，95% CI 1.2 - 3.3）和剖宫产（OR 1.5，95% CI 1.3 - 1.9）。两组中HTN和PROM均未增加。DM与所有不良结局风险增加相关。与对照组相比，所有组的住院时间均适度增加。
在这项关于患有多发性硬化症和癫痫的女性妊娠结局的大型全国性数据库研究中，胎儿宫内生长受限和剖宫产率仅略高于普通产科人群，其他不良结局并未增加。
