患有脑膜瘤的女性的妊娠与分娩
Pregnancy and Childbirth in Women With Meningioma.
作者信息
Hallan David R, Bhanja Debarati, Sciscent Bao Y, Ryan Casey, Gigliotti Michael J, Daggubati Lekhaj C, Caldwell Catherine, Rizk Elias
机构信息
Neurosurgery, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.
出版信息
Cureus. 2022 Jul 31;14(7):e27528. doi: 10.7759/cureus.27528. eCollection 2022 Jul.
Background Ten percent of women of childbearing age have histologically confirmed meningioma. To date, little is known regarding pregnancy-related outcomes for women with meningioma. Methods We used a de-identified database network (TriNetX's Research Network, https://trinetx.com/) to gather information on pregnant patients with meningioma (cohort 1) versus pregnant patients without meningioma (cohort 2). The primary outcome of interest included the impact of meningioma on mortality at one year. Secondary endpoints included ectopic or molar pregnancy, cesarean section, abortion, preterm labor, depression, pre-eclampsia/eclampsia, and craniotomy. Odds ratios (OR) with 95% confidence intervals (CI) were used to measure levels of association between each cohort and the outcomes of interest. Results A total of 1,739 patients were identified in each cohort following propensity-score matching. Mortality was seen in 23 patients (1.32%) in cohort 1 versus 26 patients (1.41%) in cohort 2 (OR 0.88, 95% CI {0.50, 1.55}, p=0.66). Ectopic/ molar pregnancy was seen in 31 (1.78%) versus 42 (2.42%) patients in cohorts 1 and 2, respectively (OR 0.73, 95% CI {0.046,1.17}, p=0.19). Cesarean section was seen in 126 (7.25%) versus 164 (9.43%) patients, respectively (OR 0.75, 95% CI {0.59,0.97}, p=0.020). Abortion was seen in 128 (7.36%) versus 183 (10.52%) patients, respectively (OR 0.68, 95% CI {0.53,0.86}, p=0.0011). Preterm labor was seen in 75 (4.31%) versus 119 (6.84%) patients, respectively (OR 0.61, 95% CI {0.46,0.83}, p=0.0012). Depression was seen in 258 (14.84%) versus 270 (15.53%) patients, respectively (OR 0.95, 95% CI {0.79,1.14}, p=0.57). Pre-eclampsia/eclampsia was seen in 3.11% versus 5.52% patients, respectively (OR 0.55, 95% CI {0.39,0.77}, p=0.0005). Craniotomy was seen in 74 (4.26%) versus 0 (0%) patients in cohort 1 and cohort 2, respectively. Conclusion Patients with meningioma were not at higher risk for pregnancy complications, including ectopic/molar pregnancy, cesarean section, abortion, preterm labor, pre-eclampsia/eclampsia, and mortality, compared to their non-meningioma counterparts. Still, coordinated care by neurosurgical and obstetrical providers may benefit women with meningiomas who are planning for pregnancy or are currently pregnant.
背景
10%的育龄女性经组织学确诊患有脑膜瘤。迄今为止，对于患有脑膜瘤的女性与妊娠相关的结局知之甚少。方法：我们使用了一个去识别化的数据库网络（TriNetX研究网络，https://trinetx.com/）来收集患有脑膜瘤的孕妇（队列1）与未患脑膜瘤的孕妇（队列2）的信息。感兴趣的主要结局包括脑膜瘤对一年死亡率的影响。次要终点包括异位妊娠或葡萄胎妊娠、剖宫产、流产、早产、抑郁、先兆子痫/子痫以及开颅手术。使用比值比（OR）和95%置信区间（CI）来衡量每个队列与感兴趣结局之间的关联程度。结果：倾向得分匹配后，每个队列共识别出1739例患者。队列1中有23例患者（1.32%）死亡，队列2中有26例患者（1.41%）死亡（OR 0.88，95% CI {0.50, 1.55}，p = 0.66）。队列1和队列2中分别有31例（1.78%）和42例（2.42%）患者发生异位/葡萄胎妊娠（OR 0.73，95% CI {0.046, 1.17}，p = 0.19）。剖宫产分别见于126例（7.25%）和164例（9.43%）患者（OR 0.75，95% CI {0.59, 0.97}，p = 0.020）。流产分别见于128例（7.36%）和183例（10.52%）患者（OR 0.68，95% CI {0.53, 0.86}，p = 0.0011）。早产分别见于75例（4.31%）和119例（6.84%）患者（OR 0.61，95% CI {0.46, 0.83}，p = 0.0012）。抑郁分别见于258例（14.84%）和270例（15.53%）患者（OR 0.95，95% CI {0.79, 1.14}，p = 0.57）。先兆子痫/子痫分别见于3.11%和5.52%的患者（OR 0.55，95% CI {0.39, 0.77}，p = 0.0005）。队列1中有74例（4.26%）患者接受了开颅手术，而队列2中为0例（0%）。结论：与未患脑膜瘤的女性相比，患有脑膜瘤的女性发生妊娠并发症（包括异位/葡萄胎妊娠、剖宫产、流产、早产、先兆子痫/子痫和死亡）的风险并不更高。尽管如此，神经外科和产科医护人员的协同护理可能会使计划妊娠或正在妊娠的脑膜瘤女性受益。
Zotero 插件