University of California San Francisco School of Medicine and the Division of Maternal Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California; and the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, and the Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, and the Vagelos College of Physicians and Surgeons, Columbia University, New York, New York.
Obstet Gynecol. 2022 Nov 1;140(5):861-868. doi: 10.1097/AOG.0000000000004959. Epub 2022 Oct 5.
To characterize current trends and outcomes in pregnancies complicated by cystic fibrosis (CF) that resulted in delivery.
This repeated cross-sectional study used the U.S. National Inpatient Sample to identify delivery hospitalizations of patients with CF between 2000 and 2019. Trends in delivery hospitalizations of patients with CF were assessed using joinpoint regression to determine the average annual percent change (AAPC). The risk of adverse maternal and obstetric outcomes was compared between patients with and without CF using adjusted logistic regression models accounting for demographic, clinical, and hospital characteristics, with adjusted odds ratios (aORs) with 95% CIs as measures of association. The proportion of patients with CF and other chronic conditions such as pregestational diabetes was analyzed over time.
From 2000 to 2019, the prevalence of CF at delivery increased from 2.1 to 10.4 per 100,000 deliveries (AAPC 6.7%, 95% CI 5.7-8.2%). The proportion of patients with CF and other chronic conditions increased from 18.0% to 37.3% (AAPC 3.1%, 95% CI 1.0-5.3%). Patients with CF were more likely to experience severe maternal morbidity (aOR 2.61, 95% CI 1.71-3.97), respiratory complications (aOR 17.45, 95% CI 11.85-25.68), venous thromboembolism (aOR 3.59, 95% CI 1.33-9.69), preterm delivery (aOR 2.15, 95% CI 1.79-2.59), abruption and antepartum hemorrhage (aOR 1.63, 95% CI 1.10-2.41), and gestational diabetes (aOR 2.47, 95% CI 2.47-3.70).
Although still infrequent (approximately 1 in 10,000), deliveries complicated by CF increased approximately fivefold over the study period. The proportion of patients with CF and other chronic conditions is increasing. Patients with CF are at increased risk for a broad range of adverse outcomes.
描述囊性纤维化（CF）妊娠导致分娩的当前趋势和结局。
本重复横断面研究使用美国国家住院患者样本，于 2000 年至 2019 年期间确定 CF 患者的分娩住院情况。使用 joinpoint 回归评估 CF 患者分娩住院的趋势，以确定平均年百分比变化（AAPC）。使用调整后的逻辑回归模型，根据人口统计学、临床和医院特征，比较 CF 患者和非 CF 患者不良母婴结局的风险，调整后的优势比（aOR）及其 95%置信区间（CI）作为关联的衡量指标。分析 CF 患者和其他慢性疾病（如孕前糖尿病）的比例随时间的变化情况。
2000 年至 2019 年，CF 患者在分娩时的患病率从每 100000 次分娩 2.1 例增加到 10.4 例（AAPC 6.7%，95%CI 5.7-8.2%）。CF 患者和其他慢性疾病患者的比例从 18.0%增加到 37.3%（AAPC 3.1%，95%CI 1.0-5.3%）。CF 患者更有可能经历严重的产妇发病率（aOR 2.61，95%CI 1.71-3.97）、呼吸并发症（aOR 17.45，95%CI 11.85-25.68）、静脉血栓栓塞（aOR 3.59，95%CI 1.33-9.69）、早产（aOR 2.15，95%CI 1.79-2.59）、胎盘早剥和产前出血（aOR 1.63，95%CI 1.10-2.41）和妊娠期糖尿病（aOR 2.47，95%CI 2.47-3.70）。
尽管（约每 10000 次分娩中有 1 次）仍较为罕见，但 CF 导致的分娩在研究期间增加了约五倍。CF 患者和其他慢性疾病患者的比例正在增加。CF 患者发生广泛不良结局的风险增加。
