Kadour Peero Einav, Badeghiesh Ahmad, Baghlaf Haitham, Dahan Michael H
Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, McGill University, Montreal, QC, Canada.
MUHC Reproductive Center, McGill University, Montreal, QC, Canada.
J Perinat Med. 2022 Aug 11;51(3):305-310. doi: 10.1515/jpm-2022-0075. Print 2023 Mar 28.
To explore maternal and neonatal outcomes in pregnant women with bicornuate uteri.
Retrospective population-based cohort study utilizing data from the Healthcare-Cost and Utilization Project-Nationwide Inpatient Sample (HCUP-NIS) from 2010 to 2014. There were 3,846,342 births between 2010 and 2014, included in the study. Six thousand and 195 deliveries were to women with bicornuate uterus. The remaining deliveries without other uterine anomalies were categorized as the reference group (n=3,840,147).
Pregnant women with bicornuate uterus were older and more likely to be obese (p=0.0001) with previous cesarean deliveries (CD) (31 vs. 17.1%, p=0.0001). After adjustment for confounders, they were more likely to experience pregnancy-induced hypertension (HTN) (aOR 1.21, 95%CI: 1.1-1.3), p=0.0001), preeclampsia (aOR 1.4, 95%CI: 1.2-1.6, p=0.0001) and placenta previa (aOR 1.7, 95%CI: 1.3-2.2, p=0.0001). Moreover, they were more likely to deliver preterm (aOR 2.8, 95%CI: 2.6-3.1, p=0.0001), deliver by CD (aOR 5, 95%CI: 3.1-4.1, p=0.0001), experience preterm pre-labor rupture of membranes (PPROM) (aOR 3.5, 95%CI: 2.6-3.1, p=0.0001), and have a placental abruption (aOR 3.0, 95%CI: 2.5-3.5, p=0.0001). There were increased risks of PPH (aOR 1.4, 95%CI: 1.2-1.6, p=0.0001), wound-complications (aOR 2.0, 95%CI: 1.5-2.7, p=0.0001), hysterectomy (aOR 2.6, 95%CI: 1.6-4.1, p=0.0001), blood-transfusion (aOR 1.7, 95%CI: 1.5-2.1, p=0.0001), and DIC (aOR 1.6, 95%CI: 1.1-2.5), p=0.014) in the group with bicornuate uteri. Also there was higher risk of SGA (aOR 2.9, 95%CI: 2.6-3.2, p=0.0001) and IUFD (aOR 2.5, 95%CI: 1.8-3.3, p=0.0001).
Bicornuate uteri can increase risks in pregnancy by many folds. Particularly risks of: premature delivery, CD, PPROM, placental abruption, hysterectomy, SGA and IUFD were increased 250-500%.
探讨双角子宫孕妇的母儿结局。
基于人群的回顾性队列研究，利用2010年至2014年医疗成本与利用项目全国住院样本（HCUP-NIS）的数据。2010年至2014年间共有3846342例分娩纳入研究。其中60195例为双角子宫孕妇分娩。其余无其他子宫异常的分娩归为参照组（n = 3840147）。
双角子宫孕妇年龄较大，更易肥胖（p = 0.0001），且既往有剖宫产史（31% 对17.1%，p = 0.0001）。在对混杂因素进行校正后，她们更易发生妊娠期高血压（HTN）（校正比值比[aOR] 1.21，95%可信区间[CI]：1.1 - 1.3，p = 0.0001）、子痫前期（aOR 1.4，95%CI：1.2 - 1.6，p = 0.0001）和前置胎盘（aOR 1.7，95%CI：1.3 - 2.2，p = 0.0001）。此外，她们更易早产（aOR 2.8，95%CI：2.6 - 3.1，p = 0.0001）、行剖宫产（aOR 5，95%CI：3.1 - 4.1，p = 0.0001）、发生早产胎膜早破（PPROM）（aOR 3.5，95%CI：2.6 - 3.1，p = 0.0001）及胎盘早剥（aOR 3.0，95%CI：2.5 - 3.5，p = 0.0001）。双角子宫组产后出血（PPH）（aOR 1.4，95%CI：1.2 - 1.6，p = 0.0001）、伤口并发症（aOR 2.0，95%CI：1.5 - 2.7，p = 0.0001）、子宫切除术（aOR 2.6，95%CI：1.6 - 4.1，p = 0.0001）、输血（aOR 1.7，95%CI：1.5 - 2.1，p = 0.0001）及弥散性血管内凝血（DIC）（aOR 1.6，95%CI：1.1 -
