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孕期患有肿瘤的女性的产科和婴儿结局。

Obstetrical and infant outcomes among women with neoplasms during pregnancy.

作者信息

Niu Xin, Li Christopher I, Mueller Beth A

机构信息

Department of Epidemiology, University of Washington (UW), Seattle, WA, USA.

Public Health Sciences Division, Fred Hutchinson Cancer Research Center (FHCRC), PO 19024, Mailstop M4-C308, Seattle, WA, 98109-1024, USA.

出版信息

Cancer Causes Control. 2019 Jun;30(6):651-661. doi: 10.1007/s10552-019-01167-1. Epub 2019 Apr 11.

Abstract

PURPOSE

One in 1,000 pregnancies is complicated by malignancies. Prevalence is greater for benign neoplasms. Adverse outcomes among women with malignancies have been reported. Less is known of postpartum outcomes for infants, or outcomes among women with benign neoplasms.

METHODS

We conducted a population-based cohort study using Washington State-linked vital-hospital discharge records. Women with neoplasms (707 malignant; 13,156 benign) with deliveries in 1987-2012 were identified, and a randomly selected comparison cohort. Obstetrical/infant outcomes and rehospitalization < 2 years post-delivery were compared separately for each group by multivariable regressions to estimate risk ratios (RR) and 95% confidence intervals (CI).

RESULTS

Women with either condition had increased anemia, cesarean, and preterm delivery; their infants were more often < 2,500 g or jaundiced. Women with benign conditions had increased gestational diabetes (RR = 1.20; 95% CI 1.12-1.28) and preeclampsia (RR = 1.27; 95% CI 1.18-1.36); their infants had increased malformations (RR = 1.29; 95% CI 1.19-1.38). Women with neoplasms more often were hospitalized seven or more days or rehospitalized; their infants' hospitalizations were also longer.

CONCLUSION

Malignant and benign neoplasms were associated with several adverse outcomes. Reasons for relationships of benign neoplasms with gestational diabetes, preeclampsia, and congenital malformations merit further study.

摘要

目的

每1000例妊娠中有1例合并恶性肿瘤。良性肿瘤的患病率更高。已有关于患有恶性肿瘤女性不良结局的报道。对于婴儿的产后结局或患有良性肿瘤女性的结局,人们了解较少。

方法

我们使用华盛顿州链接的生命统计-医院出院记录进行了一项基于人群的队列研究。确定了1987年至2012年期间分娩的患有肿瘤(707例恶性;13156例良性)的女性,并随机选择了一个对照队列。通过多变量回归分别比较每组的产科/婴儿结局和产后<2年的再次住院情况,以估计风险比(RR)和95%置信区间(CI)。

结果

患有这两种情况的女性贫血、剖宫产和早产的发生率均增加;她们的婴儿体重<2500g或黄疸的情况更常见。患有良性疾病的女性妊娠期糖尿病(RR = 1.20;95%CI 1.12 - 1.28)和先兆子痫(RR = 1.27;95%CI 1.18 - 1.36)的发生率增加;她们的婴儿畸形发生率增加(RR = 1.29;95%CI 1.19 - 1.38)。患有肿瘤的女性住院7天或更长时间或再次住院的情况更常见;她们婴儿的住院时间也更长。

结论

恶性和良性肿瘤与多种不良结局相关。良性肿瘤与妊娠期糖尿病、先兆子痫和先天性畸形之间关系的原因值得进一步研究。

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