Research Centre for Healthcare and Communities, Coventry University, Coventry CV1 5FB, UK.
Coventry City Council, Coventry CV1 2GN, UK.
Int J Environ Res Public Health. 2023 Oct 21;20(20):6957. doi: 10.3390/ijerph20206957.
One in 20 births could be affected by hypermobile Ehlers-Danlos syndrome or Hypermobility Spectrum Disorders (hEDS/HSD); however, these are under-diagnosed and lacking research. This study aimed to examine outcomes and complications in people childbearing with hEDS/HSD. A large online international survey was completed by women with experience in childbearing and a diagnosis of hEDS/HSD ( = 947, total pregnancies = 1338). Data were collected on demographics, pregnancy and birth outcomes and complications. Participants reported pregnancies in the UK ( = 771), USA ( = 364), Australia ( = 106), Canada ( = 60), New Zealand ( = 23) and Ireland ( = 14). Incidences were higher in people with hEDS/HSD than typically found in the general population for pre-eclampsia, eclampsia, pre-term rupture of membranes, pre-term birth, antepartum haemorrhage, postpartum haemorrhage, hyperemesis gravidarum, shoulder dystocia, caesarean wound infection, postpartum psychosis, post-traumatic stress disorder, precipitate labour and being born before arrival at place of birth. This potential for increased risk related to maternal and neonatal outcomes and complications highlights the importance of diagnosis and appropriate care considerations for childbearing people with hEDS/HSD. Recommendations include updating healthcare guidance to include awareness of these possible complications and outcomes and including hEDS/HSD in initial screening questionnaires of perinatal care to ensure appropriate consultation and monitoring can take place from the start.
每 20 例分娩中就有 1 例可能受到高活动度埃勒斯-当洛斯综合征或高活动度谱障碍(hEDS/HSD)的影响;然而,这些疾病的诊断不足,且缺乏研究。本研究旨在检查患有 hEDS/HSD 的生育人群的结局和并发症。一项大型国际在线调查由有生育经验且被诊断为 hEDS/HSD 的女性(n=947,总妊娠数=1338)完成。收集了人口统计学、妊娠和分娩结局以及并发症的数据。参与者报告了在英国(n=771)、美国(n=364)、澳大利亚(n=106)、加拿大(n=60)、新西兰(n=23)和爱尔兰(n=14)的妊娠情况。在 hEDS/HSD 患者中,子痫前期、子痫、胎膜早破早产、早产、产前出血、产后出血、妊娠剧吐、肩难产、剖宫产切口感染、产后精神病、创伤后应激障碍、急产和未到达分娩地点即分娩的发生率高于一般人群。这些与母婴结局和并发症相关的潜在高风险凸显了对患有 hEDS/HSD 的生育人群进行诊断和适当护理考虑的重要性。建议包括更新医疗保健指南,以纳入对这些可能的并发症和结局的认识,并在围产期保健的初始筛查问卷中纳入 hEDS/HSD,以确保从一开始就可以进行适当的咨询和监测。