Riihimäki Outi, Paavonen Jorma, Luukkaala Tiina, Gissler Mika, Metsäranta Marjo, Andersson Sture, Nuutila Mika, Pukkala Eero, Melin Johanna, Tikkanen Minna
Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Science Center, Tampere University Hospital, Tampere, Finland.
Acta Obstet Gynecol Scand. 2017 Nov;96(11):1315-1321. doi: 10.1111/aogs.13212. Epub 2017 Sep 19.
Women with a history of placental abruption have an increased later morbidity, but not much is known of the later mortality.
Data on women with placental abruption (index cohort) between 1969 and 2005 (n = 7805) were collected from the Finnish Hospital Discharge Register and the Finnish Medical Birth Register. A matched reference cohort consisted of women without placental abruption (n = 23 523). The causes of death were retrieved from the Cause-of-Death Register. Cause-specific mortality was compared by hazard ratios (HR). Standardized mortality ratios were calculated to compare both cohorts with the general female population. The main outcome measure was subsequent mortality.
By the end of 2013 there were 395 deaths in the index cohort and 863 deaths in the reference cohort. The overall mortality was increased in the index cohort compared with the reference cohort [HR 1.39, 95% confidence interval (CI) 1.24-1.57]. The index cohort had an increased risk of death from respiratory tract malignancies (HR 1.72, 95% CI 1.05-2.82), alcohol-related causes (HR 1.84, 95% CI 1.25-2.72), and external causes (HR 1.63, 95% CI 1.19-2.22), especially suicide (HR 1.71, 95% CI 1.07-2.74). The mortality from cardiovascular diseases did not differ. The standardized mortality ratio was increased in the index cohort compared with the general Finnish female population (HR 1.13, 95% CI 1.02-1.24), especially for respiratory tract malignancies (HR 1.79, 95% CI 1.16-2.64). The index cohort women tended to die younger than referent women (p < 0.001).
Overall mortality among women with a history of placental abruption is increased. These women tend to die younger than referent women do.
有胎盘早剥病史的女性后期发病率会升高，但关于其后期死亡率的情况人们了解得并不多。
从芬兰医院出院登记册和芬兰医学出生登记册中收集了1969年至2005年间有胎盘早剥的女性（索引队列，n = 7805）的数据。一个匹配的对照队列由无胎盘早剥的女性组成（n = 23523）。死亡原因从死亡原因登记册中获取。通过风险比（HR）比较特定病因死亡率。计算标准化死亡率以将两个队列与芬兰女性总人口进行比较。主要结局指标是后续死亡率。
到2013年底，索引队列中有395人死亡，对照队列中有863人死亡。与对照队列相比，索引队列的总体死亡率升高[HR 1.39，95%置信区间（CI）1.24 - 1.57]。索引队列因呼吸道恶性肿瘤死亡的风险升高（HR 1.72，95% CI 1.05 - 2.82），因酒精相关原因死亡的风险升高（HR 1.84，95% CI 1.25 - 2.72），以及因外部原因死亡的风险升高（HR 1.63，95% CI 1.19 - 2.22），尤其是自杀（HR 1.71，95% CI 1.07 - 2.74）。心血管疾病导致的死亡率没有差异。与芬兰女性总人口相比，索引队列的标准化死亡率升高（HR 1.13，95% CI 1.02 - 1.24），尤其是呼吸道恶性肿瘤（HR 1.79，95% CI 1.16 - 2.64）。索引队列中的女性往往比对照队列中的女性死亡年龄更小（p < 0.001）。
有胎盘早剥病史的女性总体死亡率升高。这些女性往往比对照队列中的女性死亡年龄更小。
