产妇心脏病患者的分娩方式。
Mode of delivery among women with maternal cardiac disease.
机构信息
Department of Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Obstetrics and Gynecology, Duke University School of Medicine, Durham, NC, USA.
出版信息
J Perinatol. 2023 Jul;43(7):849-855. doi: 10.1038/s41372-023-01625-4. Epub 2023 Feb 3.
OBJECTIVE
To determine if maternal cardiac disease affects delivery mode and to investigate maternal morbidity.
STUDY DESIGN
Retrospective cohort study performed using electronic medical record data. Primary outcome was mode of delivery; secondary outcomes included indication for cesarean delivery, and rates of severe maternal morbidity.
RESULTS
Among 14,160 deliveries meeting inclusion criteria, 218 (1.5%) had maternal cardiac disease. Cesarean delivery was more common in women with maternal cardiac disease (adjusted odds ratio 1.63 [95% confidence interval 1.18-2.25]). Patients delivered by cesarean delivery in the setting of maternal cardiac disease had significantly higher rates of severe maternal morbidity, with a 24.38-fold higher adjusted odds of severe maternal morbidity (95% confidence interval: 10.56-54.3).
CONCLUSION
While maternal cardiac disease was associated with increased risk of cesarean delivery, most were for obstetric indications. Additionally, cesarean delivery in the setting of maternal cardiac disease is associated with high rates of severe maternal morbidity.
目的
确定母体心脏疾病是否影响分娩方式并调查产妇发病率。
研究设计
使用电子病历数据进行回顾性队列研究。主要结局是分娩方式；次要结局包括剖宫产的指征以及严重产妇发病率的比率。
结果
在符合纳入标准的 14160 例分娩中，有 218 例（1.5%）患有母体心脏疾病。患有母体心脏疾病的妇女剖宫产更为常见（校正优势比 1.63 [95%置信区间 1.18-2.25]）。患有母体心脏疾病而行剖宫产的患者严重产妇发病率显著更高，严重产妇发病率的校正优势比为 24.38 倍（95%置信区间：10.56-54.3）。
结论
尽管母体心脏疾病与剖宫产风险增加相关，但大多数都是产科指征。此外，在母体心脏疾病的情况下进行剖宫产与严重产妇发病率高有关。
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