初产妇发生系统性硬化症的妊娠相关风险因素和发病率：一项全国基于人群的队列研究。

Pregnancy-associated risk factors and incidence of systemic sclerosis in primiparous women: A nationwide population-based cohort study.

机构信息

Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, South Korea.

Department of Healthcare Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, South Korea.

出版信息

Mod Rheumatol. 2022 Jan 5;32(1):149-154. doi: 10.1080/14397595.2021.1906513.

DOI:10.1080/14397595.2021.1906513

PMID:33775221

Abstract

OBJECTIVES

To evaluate the pregnancy-related risk factors and incidence rate (IR) of systemic sclerosis (SSc) in primipara using the Health Insurance Review and Assessment database, covering all medical claims in South Korea.

METHODS

From the database, 2,260,952 primipara aged 18-49 years from 2008 to 2018 were identified. The patients were followed up after their index delivery until December 2019. A Cox proportional hazard analysis was performed to identify the association of pregnancy-related factors with SSc development.

RESULTS

The SSc IR was 0.62 cases per 100,000 patient-years. Primipara had a higher risk of developing SSc after 3 years postpartum than in the first 3 years of delivery (OR = 1.98, 95% CI: 1.36-2.78, p < .001). A multivariate analysis showed that older age (35-49 years) (HR = 2.14, 95% CI: 1.05-4.35, p = .037) and a Caesarean section (CS) (HR = 1.86, 95% CI: 1.10-3.15, p = .021) are risk factors for SSc. At 3 years postpartum, CS (HR = 2.97, 95% CI: 1.39-6.32, p = .005) and a female infant (HR = 2.28, 95% CI: 1.11-4.71, p = .026) were associated with SSc development.

CONCLUSION

Having a CS, late childbirth, and a female infant are the risk factors for SSc in primipara. This study establishes the IR of SSc in primipara.

摘要

目的

利用韩国健康保险审查与评估数据库（涵盖所有医疗索赔），评估初产妇中与妊娠相关的系统性硬化症（SSc）发病风险因素和发病率（IR）。

方法

从数据库中确定了 2008 年至 2018 年间年龄在 18 至 49 岁的 2260952 名初产妇。这些患者在分娩后的指数随访期间，直至 2019 年 12 月。采用 Cox 比例风险分析来确定与 SSc 发病相关的妊娠相关因素。

结果

SSc 的 IR 为 0.62 例/100000 患者年。与分娩后的前 3 年相比，初产妇在产后 3 年后发生 SSc 的风险更高（OR=1.98，95%CI：1.36-2.78，p<0.001）。多变量分析显示，年龄较大（35-49 岁）（HR=2.14，95%CI：1.05-4.35，p=0.037）和剖宫产（CS）（HR=1.86，95%CI：1.10-3.15，p=0.021）是 SSc 的危险因素。产后 3 年，CS（HR=2.97，95%CI：1.39-6.32，p=0.005）和女婴（HR=2.28，95%CI：1.11-4.71，p=0.026）与 SSc 发病相关。