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加拿大蒙特利尔一家四级医疗中心孕产妇重症监护病房收治情况的趋势,以及产妇年龄对重症监护结局的影响。

Trends in maternal ICU admissions at a quaternary centre in Montreal, Canada, and impact of maternal age on critical care outcomes.

作者信息

Lopez Laporte Maria Agustina, Shahin Jason, Blotsky Andrea, Malhamé Isabelle, Dayan Natalie

机构信息

Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.

Division of Respirology and Critical Care Medicine, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada.

出版信息

Obstet Med. 2024 Jun;17(2):84-91. doi: 10.1177/1753495X231184686. Epub 2023 Jul 4.

Abstract

BACKGROUND

Advancing maternal age is increasingly prevalent and is associated with severe maternal morbidity often requiring intensive care unit (ICU) admission.

OBJECTIVES

To describe maternal ICU admissions at a quaternary care hospital in Montreal, Canada, and evaluate the association between maternal age and composite of: need for invasive interventions, ICU stay > 48 h, or maternal death.

METHODS

Chart review of ICU admissions during pregnancy/postpartum (2006-2016); logistic regressions to evaluate the impact of age on outcomes.

RESULTS

With 5.1 ICU admissions per 1000 deliveries, we included 187 women (mean age 32 ± 6.3 years; 20 (10.7%) ≥ 40 years). The composite outcome occurred in 105 (56.2%) patients; there were two maternal deaths. Age ≥ 40 years increased the odds of invasive interventions (OR 4.03; 95% confidence interval [CI] 1.15-14.1) but not of the composite outcome (OR 2.30; 95% CI 0.66-8.02).

CONCLUSION

Peripartum women aged ≥ 40 years had worse outcomes in ICU, with an increased need for invasive interventions.

摘要

背景

高龄产妇越来越普遍,且与严重的孕产妇发病相关,常需入住重症监护病房(ICU)。

目的

描述加拿大蒙特利尔一家四级护理医院的孕产妇ICU入院情况,并评估产妇年龄与以下综合情况之间的关联:需要侵入性干预、ICU住院时间>48小时或孕产妇死亡。

方法

对妊娠/产后期间(2006 - 2016年)入住ICU的病例进行图表回顾;采用逻辑回归评估年龄对结局的影响。

结果

每1000例分娩中有5.1例入住ICU,我们纳入了187名女性(平均年龄32±6.3岁;20名(10.7%)年龄≥40岁)。105名(56.2%)患者出现了综合结局;有2例孕产妇死亡。年龄≥40岁增加了侵入性干预的几率(比值比[OR]4.03;95%置信区间[CI]1.15 - 14.1),但未增加综合结局的几率(OR 2.30;95%CI 0.66 - 8.02)。

结论

年龄≥40岁的围产期女性在ICU的结局较差,侵入性干预需求增加。

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