产妇年龄与分娩并发症风险
Maternal age and risk of labor and delivery complications.
作者信息
Cavazos-Rehg Patricia A, Krauss Melissa J, Spitznagel Edward L, Bommarito Kerry, Madden Tessa, Olsen Margaret A, Subramaniam Harini, Peipert Jeffrey F, Bierut Laura Jean
机构信息
Department of Psychiatry, Washington University School of Medicine, Campus Box 8134, 660 South Euclid, St. Louis, MO, 63110, USA,
出版信息
Matern Child Health J. 2015 Jun;19(6):1202-11. doi: 10.1007/s10995-014-1624-7.
We utilized an updated nationally representative database to examine associations between maternal age and prevalence of maternal morbidity during complications of labor and delivery. We used hospital inpatient billing data from the 2009 United States Nationwide Inpatient Sample, part of the Healthcare Cost and Utilization Project. To determine whether the likelihood that maternal morbidity during complications of labor and delivery differed among age groups, separate logistic regression models were run for each complication. Age was the main independent variable of interest. In analyses that controlled for demographics and clinical confounders, we found that complications with the highest odds among women, 11-18 years of age, compared to 25-29 year old women, included preterm delivery, chorioamnionitis, endometritis, and mild preeclampsia. Pregnant women who were 15-19 years old had greater odds for severe preeclampsia, eclampsia, postpartum hemorrhage, poor fetal growth, and fetal distress. Pregnant women who were ≥35 years old had greater odds for preterm delivery, hypertension, superimposed preeclampsia, severe preeclampsia, and decreased risk for chorioamnionitis. Older women (≥40 years old) had increased odds for mild preeclampsia, fetal distress, and poor fetal growth. Our findings underscore the need for pregnant women to be aware of the risks associated with extremes of age so that they can watch for signs and symptoms of such complications.
我们利用一个更新的全国代表性数据库,来研究产妇年龄与分娩并发症期间产妇发病率之间的关联。我们使用了来自2009年美国全国住院患者样本的医院住院计费数据,该样本是医疗成本与利用项目的一部分。为了确定分娩并发症期间产妇发病的可能性在不同年龄组之间是否存在差异,我们针对每种并发症分别运行了逻辑回归模型。年龄是主要的研究自变量。在控制了人口统计学和临床混杂因素的分析中,我们发现,与25 - 29岁的女性相比,11 - 18岁女性中几率最高的并发症包括早产、绒毛膜羊膜炎、子宫内膜炎和轻度先兆子痫。15 - 19岁的孕妇发生重度先兆子痫、子痫、产后出血、胎儿生长受限和胎儿窘迫的几率更高。≥35岁的孕妇发生早产、高血压、叠加性先兆子痫、重度先兆子痫的几率更高,而发生绒毛膜羊膜炎的风险降低。年龄较大的女性(≥40岁)发生轻度先兆子痫、胎儿窘迫和胎儿生长受限的几率增加。我们的研究结果强调,孕妇需要了解与极端年龄相关的风险,以便能够留意此类并发症的体征和症状。