Sebastian Natasha, Czuzoj-Shulman Nicholas, Spence Andrea R, Abenhaim Haim Arie
Department of Obstetrics and Gynecology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.
Center for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montreal, Quebec, Canada.
J Gynecol Obstet Hum Reprod. 2021 Nov;50(9):102161. doi: 10.1016/j.jogoh.2021.102161. Epub 2021 May 10.
Although urolithiasis is relatively common in the general population, there is limited information on this condition available in the pregnant population. The objectives of this study are to identify the incidence of urolithiasis in pregnancy, as well as to compare maternal and fetal outcomes associated with urolithiasis in pregnancy.
Using the Healthcare Cost and Utilization Project-Nationwide Inpatient Sample database from the United States, a population-based retrospective cohort study consisting of pregnant women who delivered between 1999 and 2015 was conducted. ICD-9-CM code 592.X was used to identify pregnant women with urolithiasis within the cohort, with pregnant women without urolithiasis forming the comparison group. Unconditional logistic regression models were used to estimate the associations between urolithiasis in pregnancy and maternal and neonatal outcomes, while adjusting for baseline maternal characteristics.
A cohort of 13,792,544 pregnant women was identified, of which 11,528 had a urolithiasis-related admission during pregnancy, for an overall incidence of 8.3 per 10,000 pregnancies. Women with urolithiasis had a greater risk of developing preeclampsia/eclampsia, OR 1.35(95% CI 1.24-1.47), gestational diabetes, 1.29(1.20-1.30), abruptio placenta, 1.41(1.22-1.64), placenta previa, 1.55(1.27-1.90), pyelonephritis, 88.87(81.69-96.69), venous thromboembolism, 1.65(1.23-2.22), and more likely to deliver by cesarean, 1.20(1.15-1.25). As well, maternal death was more common among these women, 2.85(1.07-7.60). Congenital anomalies, 2.84(2.43-3.31) and prematurity, 1.92(1.82-2.03) were more commonly found among babies born to women with urolithiasis.
Although the mechanism is unclear, women with urolithiasis in pregnancy have an increased risk of adverse pregnancy and newborn outcomes.
尽管尿石症在普通人群中相对常见，但关于孕妇患此病的信息有限。本研究的目的是确定孕期尿石症的发病率，并比较与孕期尿石症相关的母婴结局。
利用美国医疗成本与利用项目全国住院样本数据库，开展了一项基于人群的回顾性队列研究，研究对象为1999年至2015年间分娩的孕妇。使用ICD-9-CM编码592.X来识别队列中患有尿石症的孕妇，未患尿石症的孕妇作为对照组。采用无条件逻辑回归模型来估计孕期尿石症与母婴结局之间的关联，同时对产妇的基线特征进行调整。
共识别出13792544名孕妇队列，其中11528名在孕期因尿石症入院，总体发病率为每10000例妊娠8.3例。患尿石症的女性发生先兆子痫/子痫的风险更高，比值比为1.35（95%置信区间1.24-1.47），患妊娠期糖尿病的风险为1.29（1.20-1.30），胎盘早剥的风险为1.41（1.22-1.64），前置胎盘的风险为1.55（1.27-1.90），肾盂肾炎的风险为88.87（81.69-96.69），静脉血栓栓塞的风险为1.65（1.23-2.22），且更有可能通过剖宫产分娩，比值比为1.20（1.15-1.25）。此外，这些女性中孕产妇死亡更为常见，比值比为2.85（1.07-7.60）。先天性异常的比值比为2.84（2.43-3.31），早产的比值比为1.92（1.82-2.03），在患尿石症女性所生的婴儿中更为常见。
尽管机制尚不清楚，但孕期患尿石症的女性发生不良妊娠和新生儿结局的风险增加。
