Jelin Angie C, Sharshiner Rita, Caughey Aaron B
a Department of Gynecology and Obstetrics , Johns Hopkins University , Baltimore , MD , USA and.
b Department of Obstetrics and Gynecology , Oregon Health Sciences University , Portland , OR , USA.
J Matern Fetal Neonatal Med. 2017 Jan;30(1):4-7. doi: 10.3109/14767058.2016.1161747. Epub 2016 Apr 6.
To evaluate maternal co-morbidities and adverse perinatal outcomes associated with cystic fibrosis (CF).
This is a retrospective cohort study of 2 178 954 singleton pregnancies at ≥20 weeks' gestation with and without CF in the state of California during the years 2005-2008. ICD-9 codes and linked hospital discharge and vital statistics data were utilized. Rates of maternal co-morbidities, fetal congenital anomalies and adverse perinatal outcomes were compared in those with CF and those without. Maternal co-morbidities included gestational hypertension, preeclampsia, gestational diabetes and primary cesarean delivery. Perinatal outcomes included neonatal demise, preterm birth, intrauterine growth restriction, macrosomia, anomaly, fetal demise, asphyxia, respiratory distress syndrome, jaundice, intraventricular hemorrhage, hypoglycemia and necrotizing enterocolitis.
The cohort included 2 178 954 pregnancies of which 77 mothers had CF. Mothers with CF were more likely to have pre-gestational diabetes and had higher rates of primary cesarean delivery. Neonates delivered to mothers with CF were more likely to be born preterm and have congenital anomalies but otherwise were not at increased risk for significant neonatal morbidity or mortality when adjusted for gestational age.
Mothers with CF are more likely to have pre-gestational diabetes, deliver preterm (<37 weeks gestation) and have a primary cesarean delivery. Infants are more likely to have congenital anomalies. In addition to early diabetic screening and genetic counseling, a detailed fetal anatomy ultrasound should be performed in women with CF.
评估与囊性纤维化（CF）相关的孕产妇合并症及不良围产期结局。
这是一项回顾性队列研究，研究对象为2005年至2008年加利福尼亚州2178954例妊娠≥20周的单胎妊娠，其中有或无CF。使用国际疾病分类第九版（ICD - 9）编码以及相关的医院出院和生命统计数据。比较了患有CF和未患有CF的孕妇的合并症发生率、胎儿先天性异常及不良围产期结局。孕产妇合并症包括妊娠期高血压、先兆子痫、妊娠期糖尿病和初次剖宫产。围产期结局包括新生儿死亡、早产、宫内生长受限、巨大儿、畸形、胎儿死亡、窒息、呼吸窘迫综合征、黄疸、脑室内出血、低血糖和坏死性小肠结肠炎。
该队列包括2178954例妊娠，其中77名母亲患有CF。患有CF的母亲更易患孕前糖尿病，初次剖宫产率更高。患有CF的母亲所分娩的新生儿更易早产且有先天性异常，但在根据孕周调整后，其他方面发生显著新生儿发病或死亡的风险并未增加。
患有CF的母亲更易患孕前糖尿病、早产（妊娠<37周）并进行初次剖宫产。婴儿更易出现先天性异常。除了早期糖尿病筛查和遗传咨询外，应对患有CF的女性进行详细的胎儿解剖超声检查。
