Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
J Dev Orig Health Dis. 2020 Dec;11(6):648-652. doi: 10.1017/S2040174419000795. Epub 2019 Nov 22.
This study aimed to assess the association between maternal-isolated oligohydramnios (IO) and offspring long-term neurological complications. A population-based retrospective cohort study was conducted, including all births at a single tertiary medical center in Israel between the years 1991 and 2014. Multiple pregnancies and potential pregnancy complications associated with oligohydramnios were excluded. The computerized obstetrical database was linked with the computerized dataset of all pediatric hospitalizations of the same medical center. Evaluation of cumulative neurological-associated hospitalizations rate over time was compared using a Kaplan-Meier survival curve. The Weibull survival parametric model was conducted to assess the neurological-associated hospitalization risk in the presence of IO, while accounting for potential confounders. A total of 190,259 pregnancies were included in the study, of which 4063 (2.13%) pregnancies were complicated with IO. Total neurological-related hospitalizations were significantly more common in the IO group (3.7% in the IO group and 3.0% in the comparison group, p = 0.005). Pervasive developmental disorder, movement disorders, developmental disorders, and degenerative and demyelization disorders were all specific neurological diagnoses significantly more common in the exposed group. The survival curve demonstrated a significantly higher cumulative hospitalization rate in the exposed group (log-rank p = 0.001). Using a multivariate model adjusting for gestational age, maternal age, and labor induction, an independent association between IO and long-term neurological morbidity of the offspring was observed (adjusted hazard ratio 1.203; 95% CI 1.02-1.42). In summary, a significant association was found between pregnancies complicated by IO and long-term neurological morbidity of the offspring.
本研究旨在评估母体孤立性羊水过少(IO)与后代长期神经并发症之间的关联。采用基于人群的回顾性队列研究,纳入 1991 年至 2014 年期间以色列一家三级医疗中心的所有分娩病例。排除多胎妊娠和与羊水过少相关的潜在妊娠并发症。将计算机化的产科数据库与同一医疗中心所有儿科住院患者的计算机数据集进行了链接。使用 Kaplan-Meier 生存曲线比较了随时间推移的累积神经相关住院率。在存在 IO 的情况下,使用 Weibull 生存参数模型评估神经相关住院风险,同时考虑潜在的混杂因素。研究共纳入 190259 例妊娠,其中 4063 例(2.13%)妊娠并发 IO。IO 组的总神经相关住院率明显更高(IO 组为 3.7%,对照组为 3.0%,p=0.005)。广泛性发育障碍、运动障碍、发育障碍以及退行性和脱髓鞘疾病在暴露组中均为更为常见的特定神经诊断。生存曲线显示,暴露组的累积住院率明显更高(对数秩检验 p=0.001)。使用调整胎龄、产妇年龄和引产的多变量模型,观察到 IO 与后代长期神经发病率之间存在独立关联(调整后的危险比 1.203;95%CI 1.02-1.42)。总之,与 IO 相关的妊娠与后代的长期神经发病率之间存在显著关联。