• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

双重、三重和四重风险:患有两种或多种合并症且有更高严重产妇发病率和产后再入院风险的孕妇。

Double, Triple, and Quadruple Jeopardy: Entering Pregnancy With Two or More Multimorbid Diagnoses and Increased Risk of Severe Maternal Morbidity and Postpartum Readmission.

机构信息

Emory University School of Medicine, Department of Gynecology and Obstetrics, Atlanta, Georgia.

Grady Memorial Hospital, Atlanta, Georgia.

出版信息

Womens Health Issues. 2022 Nov-Dec;32(6):607-614. doi: 10.1016/j.whi.2022.06.005. Epub 2022 Jul 11.

DOI:10.1016/j.whi.2022.06.005
PMID:35835642
Abstract

INTRODUCTION

Multimorbidity, the presence of two or more chronic disease diagnoses, is associated with an increased risk of mortality and high health care costs in the general population and older adults. However, little evidence is available about the prevalence and impact of multimorbidity in obstetric populations. The goal of this analysis was to estimate the association between multimorbidity and severe maternal morbidity (SMM) and 90-day postpartum readmission in an obstetric cohort in Atlanta, Georgia.

STUDY DESIGN

We conducted a retrospective cohort study of livebirths and stillbirths at Grady Memorial Hospital, from October 2015 to April 2021. To determine preexisting chronic conditions, we linked information on births to inpatient diagnoses within the prior year. Multimorbidity was defined as the presence of two or more chronic disease diagnoses at birth or within the prior year. We conducted multivariable log binomial regression to estimate risk ratios and 95% confidence intervals for the crude and adjusted (for age, race/ethnicity, parity, and insurance) association between multimorbidity (two or more chronic conditions vs. zero or one) and SMM (at or within 42 days after birth) or 90-day postpartum readmission for any reason.

RESULTS

Of 14,225 included births, 10.1% were to patients with multimorbidity. Overall, SMM complicated 7.5% of births, and the 90-day readmission rate was 2.4%. Both SMM and readmission were more common among women with multimorbidity (SMM, 18.6% among women with multimorbidity compared with 6.3% without; 90-day readmission, 5.4% compared with 2.1%). Adjusting for potential confounders, multimorbidity was associated with increased risk of SMM (adjusted risk ratio, 2.9; 95% confidence interval, 2.5-3.0) and readmission (adjusted risk ratio, 2.2; 95% confidence interval, 1.7-2.9).

CONCLUSIONS

Individuals entering pregnancy with two or more chronic diseases were at an increased risk of SMM and postpartum readmission compared with individuals with one or zero chronic disease diagnoses.

摘要

简介

多种疾病,即两种或两种以上的慢性疾病诊断,与一般人群和老年人的死亡率增加和高医疗保健费用相关。然而,关于产科人群中多种疾病的患病率和影响的证据很少。本分析的目的是估计在佐治亚州亚特兰大的产科队列中,多种疾病与严重产妇发病率(SMM)和 90 天产后再入院之间的关联。

研究设计

我们对 2015 年 10 月至 2021 年 4 月在 Grady Memorial 医院的活产和死产进行了回顾性队列研究。为了确定预先存在的慢性疾病,我们将出生信息与前一年的住院诊断相关联。多种疾病定义为出生时或前一年存在两种或两种以上慢性疾病诊断。我们进行了多变量对数二项式回归,以估计多种疾病(两种或两种以上慢性疾病与零种或一种)与 SMM(分娩后 42 天内或之内)或任何原因的 90 天产后再入院之间的粗比值比和 95%置信区间,并进行了调整(年龄、种族/族裔、产次和保险)。

结果

在纳入的 14225 例分娩中,有 10.1%的产妇患有多种疾病。总体而言,SMM 使 7.5%的分娩复杂化,90 天的再入院率为 2.4%。患有多种疾病的女性中 SMM 和再入院更为常见(患有多种疾病的女性中 SMM 为 18.6%,而无多种疾病的女性中为 6.3%;90 天再入院率为 5.4%,而无多种疾病的女性中为 2.1%)。调整潜在混杂因素后,多种疾病与 SMM 的风险增加相关(调整后的风险比,2.9;95%置信区间,2.5-3.0)和再入院(调整后的风险比,2.2;95%置信区间,1.7-2.9)。

结论

与只有一种或零种慢性疾病诊断的个体相比,进入妊娠时患有两种或两种以上慢性疾病的个体发生 SMM 和产后再入院的风险增加。

相似文献

1
Double, Triple, and Quadruple Jeopardy: Entering Pregnancy With Two or More Multimorbid Diagnoses and Increased Risk of Severe Maternal Morbidity and Postpartum Readmission.双重、三重和四重风险:患有两种或多种合并症且有更高严重产妇发病率和产后再入院风险的孕妇。
Womens Health Issues. 2022 Nov-Dec;32(6):607-614. doi: 10.1016/j.whi.2022.06.005. Epub 2022 Jul 11.
2
Severe maternal morbidity at delivery and postpartum readmission in the United States.美国分娩和产后再次入院的严重产妇发病率。
Paediatr Perinat Epidemiol. 2021 Nov;35(6):627-634. doi: 10.1111/ppe.12762. Epub 2021 Mar 18.
3
Hospital Readmission Following Delivery With and Without Severe Maternal Morbidity.分娩后有无严重产妇并发症的住院再入院情况。
J Womens Health (Larchmt). 2021 Dec;30(12):1736-1743. doi: 10.1089/jwh.2020.8815. Epub 2021 May 11.
4
Risk for postpartum readmissions and associated complications based on maternal age.基于产妇年龄的产后再入院风险和相关并发症。
J Matern Fetal Neonatal Med. 2021 May;34(9):1375-1381. doi: 10.1080/14767058.2019.1637411. Epub 2019 Jul 4.
5
Postpartum Hospital Readmissions With and Without Severe Maternal Morbidity Within 1 Year of Birth, Oregon, 2012-2017.2012-2017 年俄勒冈州产后 1 年内有无严重产妇病状的住院再入院情况。
Am J Epidemiol. 2023 Feb 1;192(2):158-170. doi: 10.1093/aje/kwac183.
6
Postpartum Psychiatric Outcomes following Severe Maternal Morbidity in an Urban Safety-Net Hospital.城市安全网医院严重孕产妇发病后的产后精神科结局
Am J Perinatol. 2024 May;41(S 01):e809-e817. doi: 10.1055/a-1948-3093. Epub 2022 Sep 21.
7
Severe Maternal Morbidity and Postpartum Readmission Through 1 Year.严重孕产妇发病率及产后1年内再入院情况
Obstet Gynecol. 2023 May 1;141(5):949-955. doi: 10.1097/AOG.0000000000005150. Epub 2023 Apr 5.
8
Severe Maternal Morbidity at Delivery and Risk of Hospital Encounters Within 6 Weeks and 1 Year Postpartum.分娩时的严重产妇发病率与产后 6 周和 1 年内住院的风险。
J Womens Health (Larchmt). 2018 Feb;27(2):140-147. doi: 10.1089/jwh.2017.6437. Epub 2017 Sep 27.
9
Maternal Health after Stillbirth: Postpartum Hospital Readmission in California.胎死宫内后的产妇健康:加利福尼亚州产后住院再入院。
Am J Perinatol. 2021 Aug;38(S 01):e137-e145. doi: 10.1055/s-0040-1708803. Epub 2020 May 4.
10
Postpartum readmission and uninsurance at readmission for Medicaid vs privately insured births.产后再入院情况以及医疗补助计划覆盖分娩与私人保险分娩再入院时的未参保情况
Am J Obstet Gynecol MFM. 2022 Mar;4(2):100553. doi: 10.1016/j.ajogmf.2021.100553. Epub 2021 Dec 14.

引用本文的文献

1
Pregnancy with multiple high-risk factors: a systematic review and meta-analysis.具有多种高危因素的妊娠:一项系统评价和荟萃分析。
J Glob Health. 2025 Feb 7;15:04027. doi: 10.7189/jogh.15.04027.
2
Racial/ethnic differences in pre-pregnancy conditions and adverse maternal outcomes in the nuMoM2b cohort: A population-based cohort study.在 nuMoM2b 队列中,妊娠前状况和不良孕产妇结局的种族/民族差异:一项基于人群的队列研究。
PLoS One. 2024 Aug 12;19(8):e0306206. doi: 10.1371/journal.pone.0306206. eCollection 2024.
3
Trends in racial/ethnic disparities in postpartum hospital readmissions in California from 1997 to 2018.
1997年至2018年加利福尼亚州产后医院再入院的种族/族裔差异趋势。
AJOG Glob Rep. 2024 Mar 10;4(2):100331. doi: 10.1016/j.xagr.2024.100331. eCollection 2024 May.
4
Patient experiences with prenatal cell-free DNA screening in a safety net setting.患者在安全网环境下对产前无细胞 DNA 筛查的体验。
Prenat Diagn. 2024 Apr;44(4):409-417. doi: 10.1002/pd.6541. Epub 2024 Feb 29.