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中国女性妊娠丢失与全因死亡率的关系:来自中国慢性病前瞻性研究的发现。

Pregnancy Loss and Risk of All-Cause Mortality in Chinese Women: Findings From the China Kadoorie Biobank.

机构信息

Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON, Canada.

Vanke School of Public Health, Tsinghua University, Beijing, China.

出版信息

Int J Public Health. 2023 Apr 14;68:1605429. doi: 10.3389/ijph.2023.1605429. eCollection 2023.

Abstract

Pregnancy loss is a common obstetric complication that may be associated with maternal mortality. However, evidence is sparse and inconsistent. This study aims to investigate the association between pregnancy loss with the risk of all-cause mortality among Chinese women. Data on 299,582 women aged 30-79 years old from the China Kadoorie Biobank were used. Cox proportional hazard regression was conducted to investigate the association between the occurrence of pregnancy loss and all-cause mortality. Two or more pregnancy losses was associated with long-term all-cause mortality (adjusted hazard ratio (aHR) of 1.10, 95% CI: 1.03-1.18). Specifically, more than one spontaneous abortion or stillbirth was associated with long-term all-cause mortality (aHR 1.10, 95% CI: 1.01-1.21 and 1.14, 95% CI: 1.04-1.25, respectively). When stratified by the presence of cardiovascular disease or diabetes, as well as age at baseline, two or more pregnancy losses in women aged ≥50 diagnosed with cardiovascular disease (aHR 1.32, 95% CI: 1.18-1.48) or diabetes (aHR 1.30, 95% CI: 1.06-1.60) was associated with all-cause mortality. Recurrent pregnancy loss, in particular two or more spontaneous abortions and stillbirths were associated with increased risk of all-cause mortality. The associations between recurrent pregnancy losses and all-cause mortality were more pronounced in women aged ≥50 with cardiovascular disease or diabetes at baseline.

摘要

妊娠丢失是一种常见的产科并发症,可能与产妇死亡有关。然而,证据稀少且不一致。本研究旨在调查中国妇女妊娠丢失与全因死亡率之间的关系。

使用来自中国慢性病前瞻性研究的 299582 名年龄在 30-79 岁的女性数据。采用 Cox 比例风险回归分析妊娠丢失与全因死亡率之间的关系。

两次或两次以上妊娠丢失与长期全因死亡率相关(调整后的危险比 (aHR) 为 1.10,95%CI:1.03-1.18)。具体而言,多次自然流产或死胎与长期全因死亡率相关(aHR 分别为 1.10(95%CI:1.01-1.21)和 1.14(95%CI:1.04-1.25))。当按是否存在心血管疾病或糖尿病以及基线时的年龄进行分层时,≥50 岁且患有心血管疾病(aHR 为 1.32,95%CI:1.18-1.48)或糖尿病(aHR 为 1.30,95%CI:1.06-1.60)的女性中,两次或更多次妊娠丢失与全因死亡率相关。

复发性妊娠丢失,特别是两次或更多次自然流产和死胎,与全因死亡率风险增加相关。在基线时患有心血管疾病或糖尿病的≥50 岁女性中,复发性妊娠丢失与全因死亡率之间的关联更为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2da4/10140335/47a9ea5b8e49/ijph-68-1605429-g001.jpg

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