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结直肠癌孕妇的母婴结局:一项基于人群的研究。

Maternal and perinatal outcomes of pregnant patients with colorectal cancer: a population-based study.

作者信息

Niu Chengu, Zhang Jing, Sun Melody, Saeed Hassan, Han Yujing, Okolo Patrick I

机构信息

Internal Medicine Residency Program, Rochester General Hospital, 1425 Portland Avenue, Rochester, NY, 14621, USA.

Harbin Medical University, Harbin, 150081, China.

出版信息

J Cancer Res Clin Oncol. 2023 Nov;149(15):14159-14167. doi: 10.1007/s00432-023-05248-2. Epub 2023 Aug 8.

Abstract

PURPOSE

This study aimed to investigate the maternal and perinatal outcomes of pregnant patients with CRC using a large population-based database.

METHODS

A retrospective cohort study was conducted using the Nationwide Inpatient Sample (NIS) from 2009 to 2019. Pregnant patients with and without CRC were compared for demographic characteristics, comorbidities, maternal and perinatal outcomes, and hospital burden.

RESULTS

The study included 306 pregnancies with CRC and 40,887,353 pregnancies without CRC. Pregnant patients with CRC were older and more likely to be White. A significant association was observed between CRC and a history of inflammatory bowel disease or a family history of gastrointestinal cancer. Pregnant patients with CRC had higher odds of maternal death (AOR 260.99, 95% CI 33.36-2041.64), cardiac arrhythmia (AOR 13.73, 95% CI 4.21-44.76), acute kidney injury (AOR 32.6, 95% CI 5.29-200.77), severe sepsis (AOR 163.98, 95% CI 22.05-1219.65), and respiratory failure (AOR 31.67, 95% CI 4.11-243.98). Furthermore, the CRC group experienced higher odds of cesarean section (AOR 1.78, 95% CI 1.05-3.03), preterm birth (AOR 4.16, 95% CI 2.05-8.47), and intrauterine death (AOR 13.18, 95% CI 3.33-52.16). Distinct differences in maternal and perinatal outcomes were observed based on the location of CRC. Pregnant patients with CRC faced higher hospital charges and had longer hospital stays during delivery hospitalization compared to those without CRC.

CONCLUSION

Pregnant patients with CRC are at increased risk for adverse maternal and perinatal outcomes, emphasizing the importance of early detection, timely intervention, and comprehensive management during pregnancy.

摘要

目的

本研究旨在利用一个基于大人群的数据库,调查患有结直肠癌的孕妇的孕产妇和围产期结局。

方法

使用2009年至2019年的全国住院患者样本(NIS)进行了一项回顾性队列研究。比较了患有和未患有结直肠癌的孕妇的人口统计学特征、合并症、孕产妇和围产期结局以及医院负担。

结果

该研究纳入了306例患有结直肠癌的孕妇和40887353例未患有结直肠癌的孕妇。患有结直肠癌的孕妇年龄更大,更可能是白人。观察到结直肠癌与炎症性肠病病史或胃肠道癌家族史之间存在显著关联。患有结直肠癌的孕妇孕产妇死亡(调整后比值比[AOR]260.99,95%置信区间[CI]33.36 - 2041.64)、心律失常(AOR 13.73,95% CI 4.21 - 44.76)、急性肾损伤(AOR 32.6,95% CI 5.29 - 200.77)、严重脓毒症(AOR 163.98,95% CI 22.05 - 1219.65)和呼吸衰竭(AOR 31.67,95% CI 4.11 - 243.98)的几率更高。此外,结直肠癌组剖宫产(AOR 1.78,95% CI 1.05 - 3.03)、早产(AOR 4.16,95% CI 2.05 - 8.47)和宫内死亡(AOR 13.18,95% CI 3.33 - 52.16)的几率更高。根据结直肠癌的位置观察到孕产妇和围产期结局存在明显差异。与未患有结直肠癌的孕妇相比,患有结直肠癌 的孕妇面临更高的医院费用,并且在分娩住院期间住院时间更长。

结论

患有结直肠癌的孕妇出现不良孕产妇和围产期结局的风险增加,这凸显了孕期早期检测、及时干预和综合管理的重要性。

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本文引用的文献

1
Increasing Incidence of Early-Onset Colorectal Cancer.早发性结直肠癌发病率上升。
N Engl J Med. 2022 Apr 21;386(16):1547-1558. doi: 10.1056/NEJMra2200869.
2
Pregnancy After Breast Cancer: A Systematic Review and Meta-Analysis.乳腺癌后妊娠:系统评价和荟萃分析。
J Clin Oncol. 2021 Oct 10;39(29):3293-3305. doi: 10.1200/JCO.21.00535. Epub 2021 Jul 1.
5
Management and outcome of colorectal cancer during pregnancy: report of 41 cases.妊娠期结直肠癌的管理与结局:41例报告
Acta Chir Belg. 2019 Jun;119(3):166-175. doi: 10.1080/00015458.2018.1493821. Epub 2018 Jul 16.
8
Maternal and neonatal outcomes in pregnancies following colorectal cancer.结直肠癌治疗后妊娠的母婴结局。
Surg Endosc. 2013 Jul;27(7):2327-36. doi: 10.1007/s00464-012-2774-6. Epub 2013 Feb 1.
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