Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.
Department of Obstetrics and Gynecology, King Abdulaziz University, Rabigh Branch, Rabigh, Saudi Arabia.
Eur J Obstet Gynecol Reprod Biol. 2024 Sep;300:219-223. doi: 10.1016/j.ejogrb.2024.06.045. Epub 2024 Jul 1.
The pregnancy, delivery, and neonatal outcomes of pregnancies complicated by cystic fibrosis (CF) have yet to be evaluated in a prolonged, population-based study. We sought to evaluate the obstetric and neonatal outcomes in pregnant patients with CF using a national population database.
Retrospective population-based cohort study utilizing the Healthcare Cost and Utilization Project, Nationwide Inpatient Sample (HCUP-NIS). All women who delivered or had a maternal death in the US (2004-2014) were included in the study. Pregnancy, delivery, and neonatal outcomes were compared between women with an ICD-9 diagnosis of cystic fibrosis to those without.
Overall, 9 096 159 women met the inclusion criteria. Of these, 629 women (6.9/100000) had CF. Women with CF were more likely to be younger and have pregestational diabetes mellitus compared to those without. CF in pregnancy was associated with an increased risk of developing gestational diabetes mellitus [aOR 3.20 (95 %CI 2.48-4.15), p = 0.0001], placenta previa [aOR 2.74 (95 %CI 1.30-5.79), p = 0.008], preterm delivery [aOR 2.17 (95 %CI 1.71-2.77), p = 0.0001], operative vaginal delivery [aOR 1.59 (95 %CI 1.17-2.16), p = 0.003], and death [aOR 86.41 (95 %CI 30.91-241.58), p = 0.0001], and a decreased likelihood of having a spontaneous vaginal delivery [aOR 0.80 (95 %CI 0.66-0.97), p = 0.02]. Patients with CF were more likely to experience deep venous thrombosis [aOR 7.64 (95 %CI 1.90-30.72), p = 0.004] and disseminated intravascular coagulation [aOR 3.68 (95 %CI 1.37-9.87), p = 0.01] compared to those without. The risk of delivering a fetus with congenital anomalies was similar between groups.
Pregnant patients with CF have an increased risk of developing adverse maternal and delivery outcomes. As such, these patients should receive vigilant surveillance during pregnancy.
囊性纤维化（CF）妊娠、分娩和新生儿结局的评估尚未在一项长期的基于人群的研究中进行。我们试图使用国家人群数据库评估 CF 孕妇的产科和新生儿结局。
回顾性基于人群的队列研究，利用医疗保健成本和利用项目，全国住院患者样本（HCUP-NIS）。所有在美国分娩或产妇死亡的妇女（2004-2014 年）均纳入研究。将囊性纤维化 ICD-9 诊断的妇女与无囊性纤维化的妇女进行妊娠、分娩和新生儿结局比较。
总体而言，共有 9096159 名妇女符合纳入标准。其中，629 名妇女（6.9/100000）患有 CF。与无 CF 的妇女相比，CF 孕妇更年轻，且更可能患有孕前糖尿病。CF 妊娠与妊娠期糖尿病的风险增加相关 [优势比（aOR）3.20（95%CI 2.48-4.15），p=0.0001]、前置胎盘 [aOR 2.74（95%CI 1.30-5.79），p=0.008]、早产 [aOR 2.17（95%CI 1.71-2.77），p=0.0001]、阴道助产分娩 [aOR 1.59（95%CI 1.17-2.16），p=0.003]和死亡 [aOR 86.41（95%CI 30.91-241.58），p=0.0001]，且阴道自然分娩的可能性降低 [aOR 0.80（95%CI 0.66-0.97），p=0.02]。与无 CF 的妇女相比，CF 患者更有可能发生深静脉血栓形成 [aOR 7.64（95%CI 1.90-30.72），p=0.004]和弥散性血管内凝血 [aOR 3.68（95%CI 1.37-9.87），p=0.01]。两组胎儿先天畸形的风险相似。
CF 孕妇发生不良母婴和分娩结局的风险增加。因此，这些患者在怀孕期间应接受密切监测。
