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妊娠合并血色病的母婴围生结局:一项基于人群的研究。

Maternal and prenatal outcomes of hemochromatosis in pregnancy: A population-based study.

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

Clin Res Hepatol Gastroenterol. 2023 Nov;47(9):102221. doi: 10.1016/j.clinre.2023.102221. Epub 2023 Sep 27.

Abstract

BACKGROUND

This retrospective study investigated the impact of hemochromatosis on maternal and perinatal outcomes among delivery hospitalizations in the United States between 2010 and 2019, revealing notable trends and associations.

METHODS

Utilizing data from over 36 million delivery hospitalizations, we conducted a comprehensive analysis, focusing on maternal complications, perinatal outcomes, and healthcare utilization among women with hemochromatosis compared to those without.

RESULTS

Women with hemochromatosis exhibited a longer length of hospital stay (3.27 ± 0.20 days vs. 2.64 ± 0.04 days) and higher total hospital charges ($21,789.66 ± $1124.41 vs. $17,751.63 ± $97.71) compared to those without the condition. There was a significant increase in the prevalence of hemochromatosis among delivery hospitalizations over the studied period, from 1.91 per 100,000 hospitalizations to 8.65 cases per 100,000 hospitalizations. Hemochromatosis patients demonstrated a higher prevalence of hypertensive disorders of pregnancy (aOR: 1.50, 95 % CI: 1.03-2.19) and VTE(aOR: 20.35, 95 % CI: 5.05-82.05).There were no statistically significant differences in rates of peripartum hemorrhage, C-section, preterm birth, fetal growth restriction, large for gestational age infants, and fetal death between the two groups.

CONCLUSIONS

Our findings underscore higher hypertensive disorders of pregnancy and VTE among women with hemochromatosis, despite unaffected perinatal outcomes. An increasing trend in hemochromatosis prevalence highlights the need for targeted interventions and cost-effective management strategies. Future research is needed to explore potential racial disparities and understand the rising incidence of hemochromatosis among pregnant women.

摘要

背景

本回顾性研究调查了 2010 年至 2019 年期间美国分娩住院患者中血色病对母婴围产结局的影响,揭示了显著的趋势和关联。

方法

利用超过 3600 万分娩住院患者的数据,我们进行了全面分析,重点关注血色病女性与无血色病女性相比的产妇并发症、围产结局和医疗保健利用情况。

结果

与无血色病的女性相比,血色病女性的住院时间更长(3.27±0.20 天比 2.64±0.04 天),总住院费用更高(21789.66±1124.41 美元比 17751.63±97.71 美元)。研究期间,分娩住院患者中血色病的患病率显著增加,从每 10 万例住院患者 1.91 例增加到每 10 万例住院患者 8.65 例。血色病患者妊娠高血压疾病(aOR:1.50,95%CI:1.03-2.19)和静脉血栓栓塞症(aOR:20.35,95%CI:5.05-82.05)的患病率更高。两组间围产期出血、剖宫产、早产、胎儿生长受限、大于胎龄儿和胎儿死亡的发生率无统计学差异。

结论

尽管围产结局未受影响,但血色病女性妊娠高血压疾病和静脉血栓栓塞症的发生率更高。血色病患病率呈上升趋势,突出了需要采取针对性干预和具有成本效益的管理策略。需要进一步研究以探讨潜在的种族差异,并了解孕妇血色病发病率的上升。

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