Division of Women's and Children's Anesthesia, Department of Anesthesiology, Chi Mei Medical Center, 901 Zhonghua Road, Yongkang District, Tainan City, 710, Taiwan.
Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Kaohsiung, 807, Taiwan.
BMC Pregnancy Childbirth. 2018 Nov 26;18(1):460. doi: 10.1186/s12884-018-2079-4.
Whether nonobstetric surgery during gestation is associated with a higher risk of spontaneous abortion or adverse delivery outcomes is still unclear.
We performed a retrospective case-control study using a Longitudinal Health Insurance Database (LHID 2000) containing claim-data of 1 million randomly selected beneficiaries. We compared the incidences and estimated the adjusted odds ratios (aOR) with 95% confidence interval (95% CI) for spontaneous abortion, adverse delivery outcomes, cesarean delivery, and prolonged hospital stay to determine the risk of adverse outcomes in women who had nonobstetric surgery during gestation as compared to those who did not have any surgery during gestation.
After exclusion, we were left with 114,852 delivery and 3999 abortion cases in our study; and 462 (0.39%) of them had nonobstetric surgery under general or regional anesthesia during pregnancy. The leading surgeries were repair of cervical os (33.12%), appendectomy (17.32%), ovarian surgeries (13.64%), and fixation of fractured bone (8.01%).The risk of spontaneous abortion (4.23% vs. 2.43%, aOR:1.53; 95% CI: 1.01-2.31), antepartum hemorrhage (7.14% vs. 2.83%, aOR: 2.51; 95% CI: 1.74-3.61), pre-eclampsia/eclampsia (2.60% vs. 1.01%, aOR: 2.35; 95% CI: 1.30-4.23), gestational diabetes (2.38% vs. 0.69%, aOR: 3.12; 95% CI: 1.69-5.78), prematurity (9.06 vs. 4.90%, aOR: 3.31; 95% CI: 2.54-4.31), cesarean section (43.55% vs. 33.76%, aOR: 1.41; 95% CI: 1.17-1.71), and prolonged hospital stay (1.82% vs. 5.91%, aOR: 3.23; 95% CI: 2.16-4.83) were higher in those women who had nonobstetric surgery after adjusting for age and comorbidities.
Nonobstetric surgery during gestation were associated with a higher risk of spontaneous abortion, adverse delivery outcomes, cesarean section, and prolonged hospital stay.
妊娠期间非产科手术是否与自然流产或不良分娩结局风险增加有关仍不清楚。
我们使用包含 100 万随机选择受益人的纵向健康保险数据库（LHID 2000）进行了回顾性病例对照研究。我们比较了自然流产、不良分娩结局、剖宫产和住院时间延长的发生率，并估计了 95%置信区间（95%CI）的调整比值比（aOR），以确定与妊娠期间未行任何手术的女性相比，妊娠期间行非产科手术的女性发生不良结局的风险。
排除后，我们的研究中有 114852 例分娩和 3999 例流产病例；其中 462 例（0.39%）在妊娠期间接受全身或区域麻醉下进行了非产科手术。主要手术为宫颈口修复（33.12%）、阑尾切除术（17.32%）、卵巢手术（13.64%）和骨折固定（8.01%）。自然流产风险（4.23% vs. 2.43%，aOR：1.53；95%CI：1.01-2.31）、产前出血（7.14% vs. 2.83%，aOR：2.51；95%CI：1.74-3.61）、子痫前期/子痫（2.60% vs. 1.01%，aOR：2.35；95%CI：1.30-4.23）、妊娠期糖尿病（2.38% vs. 0.69%，aOR：3.12；95%CI：1.69-5.78）、早产（9.06% vs. 4.90%，aOR：3.31；95%CI：2.54-4.31）、剖宫产（43.55% vs. 33.76%，aOR：1.41；95%CI：1.17-1.71）和住院时间延长（1.82% vs. 5.91%，aOR：3.23；95%CI：2.16-4.83）在接受年龄和合并症调整后更高。
妊娠期间非产科手术与自然流产、不良分娩结局、剖宫产和住院时间延长的风险增加有关。
