李斯特菌感染孕妇的母婴结局：来自全国队列的研究结果。
Maternal and obstetric outcomes of listeria pregnancy: insights from a national cohort.
机构信息
Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
出版信息
J Matern Fetal Neonatal Med. 2022 Dec;35(25):10010-10016. doi: 10.1080/14767058.2022.2083494. Epub 2022 Jun 10.
OBJECTIVE
We sought to evaluate and describe the maternal and obstetric morbidity associated with Listeria infection in pregnancy.
METHODS
Retrospective cohort of pregnant women using the 2007-2018 National Inpatient Sample. Pregnant women with discharge diagnosis codes consistent with Listeria infection were identified. Outcomes of deliveries complicated by Listeria infection were compared to those of delivery without this infection. The primary outcome was a composite of severe maternal morbidity. Secondary outcomes included components of the composite, maternal length of stay, mode of delivery, stillbirth, and preterm delivery.
RESULTS
We identified 134 maternity associated hospitalizations for Listeria (weighted national estimate 666), of which 72 (weighted national estimate of 358) were delivery admissions. Delivery admissions complicated by Listeria resulted in higher rates of severe maternal morbidity than those without, (30.9% vs. 1.6%, <.001). In adjusted analyses, women with Listeria had 21.2-fold higher risk of severe maternal morbidity (95% CI: 14.0, 31.9) when compared to those without Listeria. Specifically, Listeria delivery admissions had higher rates of acute respiratory distress syndrome (2.8% vs. 0.1%, <.001), mechanical ventilation (1.4% vs. 0.0%, <.001), sepsis (28.1% vs. 0.1%, <.001), and shock (1.4% vs. 0.0%, <.001). Listeria delivery admissions also had higher rates of preterm birth (61.3% vs. 7.7%, < 0.001) and stillbirth (13.5% vs. 0.7%, <.001). Women hospitalized or delivered with Listeria infection were also more likely to have a cesarean delivery (57.9% vs. 32.9, <.001) and the average length of stay for women with Listeria was also longer (4.0 days vs. 2.3 days, <.001).
CONCLUSIONS
Women with Listeria infection in pregnancy have higher rates of severe maternal morbidity, specifically increased risk of sepsis, septic shock, and acute respiratory distress syndrome. Among delivery hospitalizations, these women also have higher rates of preterm birth and stillbirth.
目的
我们旨在评估和描述妊娠李斯特菌感染相关的孕产妇发病率和产科发病率。
方法
这是一项回顾性队列研究，使用了 2007 年至 2018 年全国住院患者样本。确定了符合李斯特菌感染诊断的孕妇。将李斯特菌感染引起的分娩并发症的结局与无感染的分娩结局进行比较。主要结局是严重产妇发病率的综合结果。次要结局包括复合结局的组成部分、产妇住院时间、分娩方式、死胎和早产。
结果
我们发现了 134 例与妊娠相关的李斯特菌感染住院病例（全国估计权重为 666 例），其中 72 例（全国估计权重为 358 例）为分娩住院病例。李斯特菌感染引起的分娩并发症比没有感染的分娩并发症发生率更高，（30.9%比 1.6%，<.001）。在调整分析中，与没有李斯特菌感染的女性相比，患有李斯特菌感染的女性严重产妇发病率的风险高 21.2 倍（95%置信区间：14.0，31.9）。具体来说，李斯特菌分娩并发症的急性呼吸窘迫综合征发生率更高（2.8%比 0.1%，<.001）、机械通气（1.4%比 0.0%，<.001）、败血症（28.1%比 0.1%，<.001）和休克（1.4%比 0.0%，<.001）。李斯特菌分娩并发症的早产发生率也更高（61.3%比 7.7%，<.001）和死胎率更高（13.5%比 0.7%，<.001）。患有李斯特菌感染的住院或分娩的女性也更有可能行剖宫产（57.9%比 32.9%，<.001），且李斯特菌感染女性的平均住院时间也更长（4.0 天比 2.3 天，<.001）。
结论
妊娠李斯特菌感染的女性严重产妇发病率更高，特别是败血症、感染性休克和急性呼吸窘迫综合征的风险增加。在分娩住院病例中，这些女性的早产和死胎发生率也更高。
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