Girault Aude, Blanc Julie, Gayet Vanessa, Goffinet François, Hubert Dominique
Maternité Port-Royal, Université Paris-Descartes, DHU Risk in Pregnancy, Cochin Broca Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
Unité de Médecine de la Reproduction, service de Gynécologie-Obstétrique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France.
Respir Med. 2016 Apr;113:22-7. doi: 10.1016/j.rmed.2016.02.010. Epub 2016 Feb 23.
Due to increased survival, more women with cystic fibrosis become pregnant. However, studies on the specificities of pregnancy in CF versus healthy women are lacking.
In this retrospective case-control study, we compared the maternal and perinatal outcomes of 33 pregnancies in CF women who delivered in our maternity ward from December 2000 to December 2013 and were matched to 66 controls.
The median term of delivery was similar in cases and controls (38.1 ± 1.6 vs 38.4 ± 1.1 weeks gestation). Assisted reproductive technology pregnancies were more frequent in CF women (51% vs 3%, p < 0.001). In CF women, the initial BMI was lower (mean BMI 19.5 ± 2.4 vs 22.4 ± 4.9 kg/m(2); p = 0.001) and pre-existing diabetes was more frequent (30% vs 3%; p < 0.001). Those differences persisted during pregnancy for weight gain (9.1 ± 7.1 kg vs 13.3 ± 6.4 kg; p = 0.001) and diabetes (48% vs 8%; p < 0.001). Spontaneous labor and vaginal deliveries were less frequent in CF than in controls (respectively 45% vs 70%, p = 0.002; 51% vs 70%, p = 0.11). There was an equal number of caesarean sections (24% vs 21%; p = 0.80). Neonatal outcomes were similar in both groups, including birth weight (3042 ± 91 g vs 3119 ± 92 g).
Multidisciplinary care of pregnancy in women with CF resulted in maternal and perinatal outcomes similar to those found in women in the general population.
由于生存率提高,越来越多患有囊性纤维化的女性怀孕。然而,关于囊性纤维化患者与健康女性怀孕特异性的研究尚缺。
在这项回顾性病例对照研究中,我们比较了2000年12月至2013年12月在我院产科分娩的33例囊性纤维化女性患者的孕产妇及围产期结局,并与66例对照进行匹配。
病例组和对照组的中位分娩孕周相似(38.1±1.6 vs 38.4±1.1孕周)。囊性纤维化女性患者辅助生殖技术妊娠更为常见(51% vs 3%,p<0.001)。囊性纤维化女性患者初始体重指数较低(平均体重指数19.5±2.4 vs 22.4±4.9kg/m²;p=0.001),且既往糖尿病更为常见(30% vs 3%;p<0.001)。这些差异在孕期体重增加方面(9.1±7.1kg vs 13.3±6.4kg;p=0.001)和糖尿病方面(48% vs 8%;p<0.001)持续存在。囊性纤维化患者自然分娩和阴道分娩的发生率低于对照组(分别为45% vs 70%,p=0.002;51% vs 70%,p=0.11)。剖宫产数量相当(24% vs 21%;p=0.80)。两组新生儿结局相似,包括出生体重(3042±91g vs 3119±92g)。
对患有囊性纤维化的女性进行多学科妊娠护理,其孕产妇及围产期结局与普通人群女性相似。