Department of Medicine, Division of Neurology, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Neurology. 2013 Jan 29;80(5):447-52. doi: 10.1212/WNL.0b013e31827f0efc. Epub 2013 Jan 9.
To compare the duration of birth hospitalization in mothers with multiple sclerosis (MS) and their newborns relative to the general population and to investigate the impact of MS-related clinical factors on the length of birth hospitalization stays.
Data from the British Columbia Perinatal Database Registry and the British Columbia MS database were linked in this retrospective cohort study. The duration of birth hospitalization in mothers with MS and their newborns (n = 432) were compared with a frequency-matched sample of the general population (n = 2,975) from 1998 to 2009. Clinical factors investigated included disease duration and disability, as measured by the Expanded Disability Status Scale. A multivariable model (generalized estimating equations) was used to analyze the association between MS and duration of birth hospitalization, adjusting for factors such as maternal age, diabetes, hypertension, and consecutive births to the same mother. Additional analyses included propensity score matching to further balance cohort characteristics.
Compared with the general population, the duration of birth hospitalization was not statistically or clinically different for mothers with MS or their newborns (median differences = +1.5 and +2.1 hours, respectively; adjusted p > 0.4). Lengths of birth hospitalization were not significantly associated with disease duration (adjusted p > 0.7) or level of disability (adjusted p > 0.5). Findings remained virtually unchanged after propensity score matching.
Birth hospitalization has been understudied in women with MS. Contrary to existing studies, we found that MS was not associated with a longer birth hospitalization. This study provides assurance to expectant mothers with MS, their families, and health care providers.
比较多发性硬化症(MS)母亲及其新生儿的分娩住院时间与普通人群的差异,并探讨与 MS 相关的临床因素对分娩住院时间的影响。
本回顾性队列研究对不列颠哥伦比亚省围产期数据库注册处和不列颠哥伦比亚省 MS 数据库的数据进行了关联。将 MS 母亲及其新生儿(n=432)的分娩住院时间与 1998 年至 2009 年间普通人群(n=2975)的频率匹配样本进行比较。所调查的临床因素包括疾病持续时间和残疾程度,由扩展残疾状态量表(Expanded Disability Status Scale)衡量。采用多变量模型(广义估计方程)分析 MS 与分娩住院时间之间的关联,调整了母亲年龄、糖尿病、高血压和同一母亲连续分娩等因素。进一步的分析包括倾向评分匹配,以进一步平衡队列特征。
与普通人群相比,MS 母亲及其新生儿的分娩住院时间在统计学上或临床上均无显著差异(中位数差异分别为+1.5 和+2.1 小时;调整后 p>0.4)。分娩住院时间与疾病持续时间(调整后 p>0.7)或残疾程度(调整后 p>0.5)无显著关联。在进行倾向评分匹配后,结果基本保持不变。
MS 女性的分娩住院时间研究不足。与现有研究相反,我们发现 MS 与更长的分娩住院时间无关。本研究为 MS 孕妇、她们的家庭和医疗保健提供者提供了保证。