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患有和不患有脊髓损伤的女性的妊娠、分娩和结局。

Pregnancy, labor, and delivery outcomes of women with and without spinal cord injury.

机构信息

Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA.

Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA.

出版信息

J Spinal Cord Med. 2023 May;46(3):405-413. doi: 10.1080/10790268.2021.2018155. Epub 2022 Feb 2.

Abstract

Compare outcomes in pregnant women with and without Spinal Cord Injury (SCI). Case study and inception cohort comparison. Community, primary care/referral center and university practice. Twenty-eight pregnant women (12 with SCI ( = PW-SCI) and 16 without SCI ( = PW-AB)) were enrolled. Six PW-SCI left study and six completed data collection and were matched, by age, parity, and race, with 12 PW-AB (1:2 ratio, respectively). Final analysis included 18 (78%) subjects. Not applicable. Utilizing standardized, templated medical records (published by NIH/NICHHD and DHHS) and self-report, prospective, longitudinal and retrospective details of pregnancy, labor and delivery experiences/complications were recorded for all women and their neonates. Data collection included vital signs, urinalysis, pregnancy-related conditions/complications ( UTIs, hyperglycemia), and labor, delivery, fetal outcomes. For PW-SCI, demographics, occurrences of autonomic dysreflexia (AD), pressure sores, worsening SCI conditions ( spasticity, bladder spasms, lost independence) were recorded. PW-SCI had statistically greater (P < .05) UTIs than PW-AB (three (50%) to 0 (0%), respectively). One PW-SCI (17%) reported pressure sores and one AD. Three (50%) PW-SCI and 4 (33%) PW-AB experienced a complication at delivery. Newborn mean birth weight (2854 g vs 3578 g; P = 0.12), and length (49.3 vs 45.8 cm; P = 0.32) were lower for PW-SCI than PW-AB. Head circumference was significantly less for PW-SCI than PW-AB (30.3 vs 34.5 cm; P = 0.04). Women with SCI tend to have more complicated courses of pregnancy, labor and delivery and smaller newborns than non-SCI peers. Neonatal head circumference is significantly smaller.

摘要

比较有和没有脊髓损伤 (SCI) 的孕妇的结局。病例研究和发病队列比较。社区、初级保健/转诊中心和大学实践。纳入了 28 名孕妇(12 名 SCI 孕妇(PW-SCI)和 16 名非 SCI 孕妇(PW-AB))。6 名 PW-SCI 退出研究,6 名完成数据收集,并按年龄、产次和种族与 12 名 PW-AB 配对(1:2 比例)。最终分析包括 18 名(78%)受试者。不适用。利用 NIH/NICHHD 和 DHHS 发布的标准化、模板化医疗记录和自我报告、前瞻性、纵向和回顾性的妊娠、分娩经历/并发症详细信息,记录所有女性及其新生儿的情况。数据收集包括生命体征、尿液分析、与妊娠相关的疾病/并发症(UTI、高血糖)以及分娩、分娩、胎儿结局。对于 PW-SCI,记录了人口统计学特征、自主神经反射异常 (AD)、压疮、SCI 状况恶化(痉挛、膀胱痉挛、丧失独立性)的发生情况。PW-SCI 的 UTI 发生率明显高于 PW-AB(分别为 3 名(50%)和 0 名(0%),P<.05)。1 名 PW-SCI(17%)报告有压疮,1 名有 AD。3 名(50%)PW-SCI 和 4 名(33%)PW-AB 在分娩时出现并发症。PW-SCI 新生儿的平均出生体重(2854g 与 3578g;P=0.12)和长度(49.3cm 与 45.8cm;P=0.32)均低于 PW-AB。PW-SCI 的头围明显小于 PW-AB(30.3cm 与 34.5cm;P=0.04)。与非 SCI 同龄人相比,SCI 女性的妊娠、分娩和新生儿头围过程往往更复杂。

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