Morikawa Mamoru, Cho Kazutoshi, Kojima Takashi, Chiba Kentaro, Ishikawa Satoshi, Umazume Takeshi, Nakagawa Kinuko, Yamada Takashi, Yamada Takahiro, Minakami Hisanori
Center for Perinatal Medicine, Hokkaido University Hospital, Sapporo, Japan.
J Obstet Gynaecol Res. 2017 May;43(5):866-872. doi: 10.1111/jog.13289. Epub 2017 Feb 11.
This study was performed to determine risk factors for central serous chorioretinopathy (CSC) in pregnant women.
This retrospective observational study was performed in a cohort of all 1881 women giving birth at a single center. The hospital database was searched to abstract all women diagnosed with pre-eclampsia (PE) as well as those visiting the eye clinic during the current pregnancy. Medical chart review was performed in all women diagnosed with CSC and PE.
PE developed in 73 (3.9%) women, six (8.2%) of whom visited the eye clinic for problems occurring in the current pregnancy; 47 of 1808 (2.6%) women without PE visited the eye clinic (P = 0.015). Four women were identified as having developed CSC after onset of PE, and none of those without PE developed CSC (5.5% [4/73] vs 0.0% [0/1808], respectively, P < 0.0001). Stepwise regression analysis selected four risk factors for CSC: hematocrit value > 38.0% (odds ratio [OR], 22.9; 95% confidence interval [CI], 2.12-247), serum creatinine > 0.7 mg/dL (OR, 21.7; 95%CI, 1.12-422), time interval from diagnosis of PE until delivery > 14 days (OR, 20.0; 95%CI, 1.87-214), and urine protein : creatinine ratio (mg/mg) > 4.5 (OR, 15.7; 95%CI, 0.81-304). Hematocrit value > 38.0% was finally identified as the only independent risk factor (OR, 22.9; 95%CI, 2.12-1716) for CSC in PE women.
CSC was likely to occur in PE women, especially in those with hemoconcentration as a result of plasma leakage from the circulating blood due to increased vascular permeability.
本研究旨在确定孕妇中心性浆液性脉络膜视网膜病变(CSC)的危险因素。
本回顾性观察性研究在一个单一中心分娩的1881名妇女队列中进行。检索医院数据库,提取所有被诊断为子痫前期(PE)的妇女以及在本次妊娠期间就诊于眼科门诊的妇女。对所有被诊断为CSC和PE的妇女进行病历审查。
73名(3.9%)妇女发生了PE,其中6名(8.2%)因本次妊娠出现的问题就诊于眼科门诊;1808名未发生PE的妇女中有47名(2.6%)就诊于眼科门诊(P = 0.015)。4名妇女在PE发病后被确定发生了CSC,未发生PE的妇女中无人发生CSC(分别为5.5%[4/73]和0.0%[0/1808],P < 0.0001)。逐步回归分析选择了CSC的4个危险因素:血细胞比容值> 38.0%(比值比[OR],22.9;95%置信区间[CI],2.12 - 247)、血清肌酐> 0.7 mg/dL(OR,21.7;95%CI,1.12 - 422)、从诊断PE到分娩的时间间隔> 14天(OR,20.0;95%CI,1.87 - 214)以及尿蛋白:肌酐比值(mg/mg)> 4.5(OR,15.7;95%CI,0.81 - 304)。血细胞比容值> 38.0%最终被确定为PE妇女中CSC的唯一独立危险因素(OR,22.9;95%CI,2.12 - 1716)。
CSC可能发生在PE妇女中,尤其是那些因血管通透性增加导致循环血液中血浆渗漏而出现血液浓缩的妇女。