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纤维肌痛孕妇的母婴结局:一项基于1200万例分娩的人群研究。

Maternal and neonatal outcomes among pregnant women with fibromyalgia: a population-based study of 12 million births.

作者信息

Magtanong Glenda Gatan, Spence Andrea R, Czuzoj-Shulman Nicholas, Abenhaim Haim Arie

机构信息

a Department of Obstetrics and Gynecology , Jewish General Hospital, McGill University , Montreal , QC , Canada.

b Centre for Clinical Epidemiology and Community Studies , Jewish General Hospital , Montreal , QC , Canada.

出版信息

J Matern Fetal Neonatal Med. 2019 Feb;32(3):404-410. doi: 10.1080/14767058.2017.1381684. Epub 2017 Sep 27.

Abstract

PURPOSE

Fibromyalgia (FM) is a rheumatologic disorder marked by chronic, widespread pain and associated comorbid conditions. The purpose of our study was to evaluate the effect of FM on maternal and neonatal outcomes.

METHODS

Using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from 1999 to 2013, we conducted a population-based retrospective cohort study consisting of women who delivered during that period. Logistic regression was used to compare maternal and neonatal outcomes among pregnancies in women with and without FM.

RESULTS

Of 12 584 918 births during the 15-year study period, 7758 (0.06%) were to women with FM with rates increasing over the study period. Women with FM were more commonly older in age, overweight or obese, and users of alcohol, tobacco, and illicit drugs. They were more likely to experience anxiety, depression, and bipolar disorder. Women with FM were at greater risk of gestational diabetes, preterm premature rupture of membranes, and placental abruption. Women with FM more commonly had cesarean deliveries (odds ratios (OR): 1.11, 95% CI: 1.05-1.16) and births complicated by venous thromboembolism (OR: 2.34, 95% CI: 1.91-2.86). Infants of women with FM were more likely to be premature (OR: 1.35, 95% CI: 1.25-1.46) and have intrauterine growth restriction (OR: 1.48, 95% CI: 1.30-1.68).

CONCLUSIONS

The prevalence of FM in pregnancy is rising in the US. FM is a high-risk pregnancy condition associated with adverse maternal and newborn outcomes.

摘要

目的

纤维肌痛(FM)是一种风湿性疾病,其特征为慢性广泛性疼痛及相关合并症。我们研究的目的是评估纤维肌痛对孕产妇和新生儿结局的影响。

方法

利用1999年至2013年医疗成本和利用项目全国住院患者样本,我们开展了一项基于人群的回顾性队列研究,研究对象为该时期分娩的女性。采用逻辑回归比较有和没有纤维肌痛的女性妊娠期间的孕产妇和新生儿结局。

结果

在15年的研究期内,12584918例分娩中,7758例(0.06%)为患有纤维肌痛的女性,且该比例在研究期间有所上升。患有纤维肌痛的女性年龄更大、超重或肥胖,更常使用酒精、烟草和非法药物。她们更易出现焦虑、抑郁和双相情感障碍。患有纤维肌痛的女性患妊娠期糖尿病、胎膜早破和胎盘早剥的风险更高。患有纤维肌痛的女性剖宫产更常见(比值比(OR):1.11,95%置信区间:1.05 - 1.16),且分娩并发静脉血栓栓塞的情况更多(OR:2.34,95%置信区间:1.91 - 2.86)。患有纤维肌痛的女性所生婴儿更易早产(OR:1.35,95%置信区间:1.25 - 1.46)和出现宫内生长受限(OR:1.48,95%置信区间:1.30 - 1.68)。

结论

美国孕期纤维肌痛的患病率正在上升。纤维肌痛是一种与孕产妇和新生儿不良结局相关的高危妊娠情况。

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