Fong Alex, Chau Cindy T, Pan Deyu, Ogunyemi Dotun A
Department of Obstetrics and Gynecology, University of California, Irvine Medical Center , Orange, CA , USA .
J Matern Fetal Neonatal Med. 2015 May;28(7):793-8. doi: 10.3109/14767058.2014.932766. Epub 2014 Jun 30.
To describe the incidence, antepartum, intrapartum and postpartum risk factors, and mortality rate of amniotic fluid embolism (AFE).
We used 2001-2007 California health discharge data to identify cases of AFE by ICD-9 codes.
Of 3,556,567 deliveries during the time period, we identified 182 cases of AFE, resulting in a population incidence of 5.1 in 100,000. Twenty-four of the cases resulted in death, giving a case fatality rate of 13.2%. Non-Hispanic blacks had a higher than 2-fold odds of developing AFE. AFE increased significantly with maternal age, most significantly after age 39. Cardiac disease had a nearly 70-fold higher association with AFE, cerebrovascular disorders had a 25-fold higher association, while conditions such as eclampsia, renal disease, placenta previa and polyhydramnios had nearly 7- to 13-fold higher associations. Classical cesarean delivery, abruption placentae, dilation and curettage, and amnioinfusion were all procedures highly associated with AFE.
Several antepartum and peripartum conditions and procedures are associated with significantly higher risks of amniotic fluid embolism. This information may contribute to a better understanding of the pathophysiology of AFE and potentially help identify those at the highest risk of developing this morbid condition.
描述羊水栓塞（AFE）的发病率、产前、产时和产后危险因素以及死亡率。
我们使用2001 - 2007年加利福尼亚州健康出院数据，通过国际疾病分类第九版（ICD - 9）编码识别羊水栓塞病例。
在该时间段的3556567例分娩中，我们识别出182例羊水栓塞病例，人群发病率为十万分之5.1。其中24例导致死亡，病死率为13.2%。非西班牙裔黑人发生羊水栓塞的几率高出2倍多。羊水栓塞的发生率随产妇年龄显著增加，在39岁之后最为显著。心脏病与羊水栓塞的关联高出近70倍，脑血管疾病高出25倍，而子痫、肾病、前置胎盘和羊水过多等情况的关联高出近7至13倍。经典剖宫产、胎盘早剥、刮宫术和羊膜腔灌注均为与羊水栓塞高度相关的操作。
几种产前和围产期情况及操作与羊水栓塞的风险显著升高相关。这些信息可能有助于更好地理解羊水栓塞的病理生理学，并有可能帮助识别发生这种疾病风险最高的人群。
