Department of Obstetrics & Gynecology, the Edith Wolfson Medical Center, Holon, Israel.
Department of Obstetrics & Gynecology, the Meir Medical Center, Kfar Saba, Israel.
BMC Pregnancy Childbirth. 2022 Dec 6;22(1):912. doi: 10.1186/s12884-022-05230-9.
We aimed to assess the association between isolated oligohydramnios in previous pregnancy and the incidence of placental related complications in subsequent pregnancy.
This was a retrospective cohort study of live singleton births from a single university affiliated medical center during an eleven-year period of women with two subsequent deliveries at our center. An analysis of outcomes was performed for all second deliveries, comparing women for whom their first delivery was complicated by isolated oligohydramnios (previous oligohydramnios group), and women without isolated oligohydramnios in their first delivery (control group). Patients for whom their first delivery was complicated by small for gestational age, pregnancy induced hypertension and preterm birth were excluded. The study groups were compared for obstetric and early neonatal outcomes, recurrence of oligohydramnios and a composite of placental related pregnancy complications.
A total of 213 in the previous oligohydramnios group and 5348 in the control group were compared. No differences were found between the groups in maternal age, body mass index, smoking and comorbidities. Gestational age at delivery was, 39.6 ± 1.3 vs. 39.3 ± 1.4 weeks, p = 0.006, in the previous oligohydramnios and controls respectively, although preterm birth rate was similar between the groups. The previous oligohydramnios group had a significantly higher incidence of oligohydramnios in second delivery, aOR 3.37, 95%CI 1.89-6.00, small for gestational age neonates, aOR 1.94, 95% CI 1.16-3.25, and overall placental related disorders of pregnancy, aOR 2.13, 95%CI 1.35-3.35.
Pregnancies complicated by isolated oligohydramnios are associated with an increased risk of placental related disorders in subsequent pregnancy. Isolated oligohydramnios may be the first sign of placental insufficiency and an independent manifestation of the placental related complications spectrum.
本研究旨在评估前次妊娠孤立性羊水过少与后续妊娠胎盘相关并发症发生率之间的关联。
这是一项回顾性队列研究，纳入了在 11 年间于某单一大学附属医院分娩的单胎活产儿，且这些产妇后续均在我院再次分娩。对所有第二次分娩的产妇进行结局分析，比较第一次分娩时合并孤立性羊水过少（前次羊水过少组）和第一次分娩时无孤立性羊水过少（对照组）的产妇。排除第一次分娩时合并胎儿生长受限、妊娠高血压和早产的患者。比较两组产妇的产科和新生儿早期结局、羊水过少复发情况及胎盘相关妊娠并发症的复合结局。
共比较了 213 例前次羊水过少组和 5348 例对照组的患者。两组产妇的年龄、体重指数、吸烟史和合并症等一般资料无差异。前次羊水过少组和对照组的分娩时孕龄分别为 39.6±1.3 周和 39.3±1.4 周，p=0.006。两组的早产发生率相似，但前次羊水过少组第二次分娩时羊水过少的发生率显著更高，OR 为 3.37（95%CI：1.89-6.00）；胎儿生长受限的发生率也更高，OR 为 1.94（95%CI：1.16-3.25）；胎盘相关妊娠疾病的总发生率也更高，OR 为 2.13（95%CI：1.35-3.35）。
孤立性羊水过少的妊娠与后续妊娠胎盘相关疾病的风险增加相关。孤立性羊水过少可能是胎盘功能不全的最初表现，也是胎盘相关并发症谱的独立表现。
