Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada.
J Perinat Med. 2020 Mar 26;48(3):209-216. doi: 10.1515/jpm-2019-0344.
Background Little is known about the impact of peptic ulcer disease (PUD) on pregnancy. Our objective was to evaluate the effect of PUD on pregnancy and newborn outcomes. Methods A retrospective cohort study was carried out using the Healthcare Cost and Utilization Project (HCUP)-National Inpatient Sample (NIS) from the United States. The cohort consisted of all births that took place from 1999 to 2015. PUD was classified on the basis of the International Classification of Diseases-Ninth Revision (ICD-9) coding. Multivariate logistic regression was used to evaluate the adjusted effect of PUD on maternal and neonatal outcomes. Results Of the 13,792,544 births in this cohort, 1005 were to women with PUD (7/100,000 births). Between 1999 and 2015, prevalence of PUD in pregnancy increased from 4/100,000 to 11/100,000, respectively. Women with PUD were more commonly older and more likely to have comorbid illnesses. Women with PUD were at greater risk of preeclampsia [odds ratio (OR) 2.11, 95% confidence interval (CI) 1.67-2.66], preterm premature rupture of membranes (PPROM; OR 2.16, 95% CI 1.30-3.59), cesarean delivery (OR 1.60, 95% CI 1.40-1.82), venous thromboembolism (OR 3.77, 95% CI 2.08-6.85) and maternal death (OR 24.50, 95% CI 10.12-59.32). Births to women with PUD were at increased risk of intrauterine growth restriction (IUGR; OR 1.54, 95% CI 1.11-2.14), preterm birth (OR 1.84, 95% CI 1.54-2.21), intrauterine fetal death (OR 2.18, 95% CI 1.35-3.52) and congenital anomalies (OR 2.69, 95% CI 1.59-4.56). Conclusion The prevalence of PUD in pregnancy has risen over the last several years. PUD in pregnancy should be considered a high-risk condition associated with important adverse maternal and neonatal outcomes.
目前对于消化性溃疡(PUD)对妊娠的影响知之甚少。我们的目的是评估 PUD 对妊娠和新生儿结局的影响。
本研究采用美国医疗保健成本和利用项目(HCUP)-国家住院患者样本(NIS)进行回顾性队列研究。该队列包括 1999 年至 2015 年期间所有分娩的产妇。根据国际疾病分类第 9 版(ICD-9)编码对 PUD 进行分类。多变量逻辑回归用于评估 PUD 对产妇和新生儿结局的调整影响。
在该队列的 13792544 例分娩中,有 1005 例发生在患有 PUD 的女性中(每 100000 例分娩中有 7 例)。1999 年至 2015 年间,妊娠期间 PUD 的患病率从每 100000 例 4 例增加到每 100000 例 11 例。患有 PUD 的女性通常年龄较大,并且更有可能患有合并症。患有 PUD 的女性发生子痫前期的风险更高[比值比(OR)2.11,95%置信区间(CI)1.67-2.66]、早产胎膜早破(PPROM;OR 2.16,95%CI 1.30-3.59)、剖宫产(OR 1.60,95%CI 1.40-1.82)、静脉血栓栓塞(OR 3.77,95%CI 2.08-6.85)和孕产妇死亡(OR 24.50,95%CI 10.12-59.32)的风险更大。患有 PUD 的女性所分娩的新生儿发生宫内生长受限(IUGR;OR 1.54,95%CI 1.11-2.14)、早产(OR 1.84,95%CI 1.54-2.21)、胎儿宫内死亡(OR 2.18,95%CI 1.35-3.52)和先天畸形(OR 2.69,95%CI 1.59-4.56)的风险更高。
近年来,妊娠期间 PUD 的患病率有所上升。妊娠期间的 PUD 应被视为一种与重要的不良母婴结局相关的高危情况。