Stahlman Shauna, Witkop Catherine T, Clark Leslie L, Taubman Stephen B
MSMR. 2017 Nov;24(11):22-29.
Diagnoses of "complications of pregnancy, childbirth, and the puerperium" include both morbid complications and indications for routine care of pregnant women. During 2012-2016, a total of 55,601 U.S. service members with live births (n=63,879) had 657,060 medical encounters with primary diagnoses of "pregnancy complications." The most frequent diagnoses were "other" specified conditions complicating pregnancy, childbirth, or the puerperium. Numbers of medical encounters with a primary (first-listed) diagnosis of any pregnancy-related complication or indication for care decreased marginally each year between 2012 (n=178,703) and 2016 (n=146,282). The percentage of live births affected by pre-eclampsia and gestational diabetes remained relatively stable during the surveillance period. For all age groups, percentages of live births affected by preterm labor decreased, but live births affected by obesity complications increased. The percentage of live births affected by gestational diabetes was more than twice as high for obese women, compared with non-obese women (12.4% vs. 5.5%). Findings suggest some opportunities to prevent sequelae for the mother and child and to mitigate longer-term impacts on force readiness.
“妊娠、分娩和产褥期并发症”的诊断既包括病态并发症,也包括孕妇常规护理的指征。在2012年至2016年期间,共有55,601名有活产记录的美国军人(共63,879例活产)因初步诊断为“妊娠并发症”而进行了657,060次医疗就诊。最常见的诊断是使妊娠、分娩或产褥期复杂化的其他特定病症。2012年(178,703次)至2016年(146,282次)期间,以任何与妊娠相关的并发症或护理指征作为主要(首诊)诊断的医疗就诊次数每年略有下降。在监测期内,受先兆子痫和妊娠期糖尿病影响的活产百分比相对稳定。对于所有年龄组,受早产影响的活产百分比下降,但受肥胖并发症影响的活产百分比上升。肥胖女性受妊娠期糖尿病影响的活产百分比是非肥胖女性的两倍多(分别为12.4%和5.5%)。研究结果表明存在一些机会,可以预防母婴后遗症,并减轻对部队战备状态的长期影响。