Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Canada.
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Canada.
J Matern Fetal Neonatal Med. 2021 May;34(9):1368-1374. doi: 10.1080/14767058.2019.1637410. Epub 2019 Jul 7.
Given the altered physiology of pregnancy, gastroenterologists are often reluctant to perform endoscopic procedures in pregnant women. The purpose of our study was to compare management practices and outcomes among pregnant and nonpregnant women admitted to the hospital for peptic ulcer disease (PUD).
A retrospective matched cohort study was carried out using the Healthcare Cost and Utilization Project - National Inpatient Sample from 1999 to 2015. A cohort of pregnant women with PUD was generated and compared with an age-matched cohort of nonpregnant women with PUD at a 1:5 ratio. Conditional logistic regression analyses were used to evaluate the adjusted effect of PUD on variables and outcomes of interest, including associated conditions, management and treatment types, and complications.
PUD was diagnosed in 2535 pregnant women and 12,675 age-matched nonpregnant women during the 16-year study period. As compared with nonpregnant women, pregnant women with PUD were less likely to undergo diagnostic or therapeutic esophagogastroduodenoscopies (EGD) for this indication. Outcomes including fever, infection, sepsis, shock, and transfusion were less likely to occur in pregnant women as compared to nonpregnant women. Pregnant women also experienced shorter hospital stays. Pregnant women who underwent EGD were more likely to experience a venous thromboembolism than nonpregnant women.
Pregnant women with PUD are less likely to undergo interventional diagnostic and therapeutic procedures than nonpregnant women with PUD. The reluctance to intervene in pregnancy does not appear to result in more adverse PUD-associated outcomes.
鉴于妊娠期间生理状况的改变，胃肠病学家通常不愿意在孕妇中进行内镜检查。本研究的目的是比较因消化性溃疡病（PUD）住院的孕妇和非孕妇的管理实践和结局。
使用 1999 年至 2015 年的医疗保健成本和利用项目-国家住院患者样本进行回顾性匹配队列研究。生成了一组患有 PUD 的孕妇队列，并与年龄匹配的患有 PUD 的非孕妇队列以 1:5 的比例进行比较。使用条件逻辑回归分析评估 PUD 对相关变量和感兴趣结局的调整效果，包括相关情况、管理和治疗类型以及并发症。
在 16 年的研究期间，诊断出 2535 例孕妇和 12675 例年龄匹配的非孕妇患有 PUD。与非孕妇相比，患有 PUD 的孕妇不太可能因该指征接受诊断或治疗性食管胃十二指肠镜检查（EGD）。与非孕妇相比，孕妇发生发热、感染、败血症、休克和输血等结局的可能性较小。孕妇的住院时间也较短。接受 EGD 的孕妇比非孕妇更有可能发生静脉血栓栓塞。
患有 PUD 的孕妇接受介入性诊断和治疗的可能性低于患有 PUD 的非孕妇。不愿意在怀孕期间进行干预似乎不会导致更多不良的 PUD 相关结局。
