Department of Family Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Lurie Institute for Disability Policy, Heller School, Brandeis University, Waltham, Massachusetts, USA.
J Womens Health (Larchmt). 2023 Jan;32(1):109-117. doi: 10.1089/jwh.2022.0068. Epub 2022 Aug 30.
Deaf or hard of hearing (DHH) women are at a higher risk of adverse pregnancy and birth outcomes compared with other women. However, little is known about postpartum outcomes among DHH women. The objective was to compare the risk of postpartum hospitalizations for DHH compared with non-DHH women and the leading indications for postpartum admissions. We analyzed data from the 1998-2017 Massachusetts Pregnancy to Early Life Longitudinal Data System and identified 3,546 singleton deliveries to DHH women and 1,381,439 singleton deliveries to non-DHH women. We used Cox proportional hazard models to compare the first hospital admission and ≥2 hospital admissions between DHH and non-DHH women within 1-42, 43-90, and 91-365 days after delivery. DHH women had a higher risk for any hospital admissions across all periods (hazard ratios [HR] = 1.84; 95% confidence intervals [CI] 1.46-2.34 within 1-42 days; HR = 2.76; 95%CI 1.99-3.83 within 43-90 days; and HR = 3.10; 95%CI 2.66-3.60 91-365 days) after childbirth compared with non-DHH women. They had an almost seven times higher risk for repeated hospital admissions within 43-90 days (HR = 6.84; 95%CI 1.66-28.21) and nearly four times higher the risk within 91-365 days (HR = 3.63; 95%CI 2.00-6.59) after delivery compared with non-DHH women. The leading indications for readmission among DHH women included: conditions complicating the puerperium/hemorrhage and soft tissues disorders. Compared with other women, DHH women had significantly higher readmissions across all postpartum periods and for repeated admissions >42 days. Leading postpartum indications were distinct from those of non-DHH women.
聋或重听(DHH)的女性与其他女性相比,妊娠和分娩结局不良的风险更高。然而,对于 DHH 女性的产后结局知之甚少。目的是比较 DHH 与非 DHH 女性产后住院的风险,以及导致产后入院的主要原因。
我们分析了 1998 年至 2017 年马萨诸塞州妊娠至早期生命纵向数据系统的数据,确定了 3546 例 DHH 女性的单胎分娩和 1381439 例非 DHH 女性的单胎分娩。我们使用 Cox 比例风险模型比较了 DHH 和非 DHH 女性在分娩后 1-42、43-90 和 91-365 天内的首次住院和≥2 次住院。
在所有时间段内,DHH 女性的任何住院治疗风险都较高(分娩后 1-42 天内的风险比[HR] = 1.84;95%置信区间[CI]为 1.46-2.34;分娩后 43-90 天内的 HR = 2.76;95%CI 为 1.99-3.83;分娩后 91-365 天内的 HR = 3.10;95%CI 为 2.66-3.60)。与非 DHH 女性相比,她们在分娩后 43-90 天内再次住院的风险几乎高出七倍(HR = 6.84;95%CI 为 1.66-28.21),分娩后 91-365 天内的风险高出近四倍(HR = 3.63;95%CI 为 2.00-6.59)。DHH 女性再次入院的主要原因包括:产褥期并发症/出血和软组织疾病。
与其他女性相比,DHH 女性在所有产后阶段的再入院率均明显更高,且>42 天的再次入院率也更高。产后主要入院原因与非 DHH 女性不同。