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