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妊娠期非传染性疾病的模式及其对母婴结局的影响:一项前瞻性观察性研究。

Pattern of non-communicable diseases during pregnancy and their effect on feto-maternal outcome: A prospective observational study.

机构信息

Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Department of Community Medicine and School of Public Health, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

出版信息

Int J Gynaecol Obstet. 2022 Feb;156(2):331-335. doi: 10.1002/ijgo.13678. Epub 2021 Mar 31.

DOI:10.1002/ijgo.13678
PMID:33730403
Abstract

OBJECTIVE

To assess patterns of non-communicable diseases (NCDs) and pregnancy outcomes of women in a tertiary care hospital.

METHODS

This was a prospective observational study, conducted over 1 year. All NCDs in women who delivered or aborted were studied. Maternal and neonatal outcomes were noted.

RESULTS

In all, 1003 NCDs occurred in 894 women. Chronic hypertension was the commonest, involving 309 (30.8%) women. Others included cardiovascular (159, 15.9%), neurological (142, 14.2%), endocrine (115, 11.5%), autoimmune (76, 7.6%), chronic kidney (48, 4.8%), and chronic respiratory (43, 4.3%) diseases, psychiatric disorders (38, 3.8%), cancers (20, 2.0%), and chronic liver disease (18, 1.8%). Most (599, 67.0%) were diagnosed before pregnancy and 145 (16.2%), 81 (9.1%), and 69 (7.7%) were diagnosed in the first, second, and third trimesters, respectively. Maternal deaths occurred in 6 (0.7%) women and near miss in 19 (2.1%) women. Only 9 (1.5%) women with NCD diagnosed before pregnancy had maternal near miss or death, compared with 16 (5.4%) diagnosed during pregnancy (P < 0.001). Of live births, 281 (35.3%) were low birth weight, 49 (6.1%) were very low birth weight, and 24 (3.0%) were extremely low birth weight.

CONCLUSION

Chronic hypertension was the commonest NCD, which along with cardiovascular and neurological disorders constituted around 60% of all NCDs. One-third of NCDs were initially diagnosed during pregnancy. Maternal morbidity was lower if NCDs were diagnosed before pregnancy.

摘要

目的

评估一家三级保健医院女性的非传染性疾病(NCDs)模式和妊娠结局。

方法

这是一项为期 1 年的前瞻性观察性研究。研究了在分娩或流产的女性中出现的所有 NCD。记录了母婴结局。

结果

共有 894 名女性发生了 1003 例 NCD。最常见的是慢性高血压,涉及 309 名(30.8%)女性。其他包括心血管疾病(159 例,15.9%)、神经系统疾病(142 例,14.2%)、内分泌疾病(115 例,11.5%)、自身免疫性疾病(76 例,7.6%)、慢性肾病(48 例,4.8%)和慢性呼吸系统疾病(43 例,4.3%)、精神疾病(38 例,3.8%)、癌症(20 例,2.0%)和慢性肝病(18 例,1.8%)。大多数(599 例,67.0%)在妊娠前诊断,145 例(16.2%)、81 例(9.1%)和 69 例(7.7%)分别在第一、二和第三个三个月诊断。有 6 名(0.7%)妇女死亡,19 名(2.1%)妇女出现严重孕产妇病。仅 9 名(1.5%)在妊娠前诊断为 NCD 的妇女发生孕产妇严重病或死亡,而在妊娠期间诊断为 NCD 的妇女有 16 名(5.4%)(P<0.001)。活产儿中,281 名(35.3%)体重偏低,49 名(6.1%)极低体重,24 名(3.0%)极低体重。

结论

慢性高血压是最常见的 NCD,加上心血管和神经系统疾病,占所有 NCD 的约 60%。三分之一的 NCD 最初在妊娠期间诊断。如果 NCD 在妊娠前诊断,产妇发病率较低。

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