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哮喘女性妊娠中的母婴结局

Infant and maternal outcomes in the pregnancies of asthmatic women.

作者信息

Demissie K, Breckenridge M B, Rhoads G G

机构信息

Department of Family Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

出版信息

Am J Respir Crit Care Med. 1998 Oct;158(4):1091-5. doi: 10.1164/ajrccm.158.4.9802053.

Abstract

We examined the relationship between infant and maternal outcomes and asthma complicating pregnancy, using historical cohort analysis of singleton live deliveries in New Jersey hospitals between 1989 and 1992 (n = 447,963). Subject mother-infant dyads were identified from linked birth certificate and maternal and newborn hospital claims data. Women with an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis code (493) for asthma (n = 2,289) were compared with a fourfold larger randomly selected control sample (n = 9,156) from the remaining pool of women. After controlling for the effects of important confounding variables, maternal asthma was associated with the following adverse infant outcomes: preterm infant (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.18 to 1.55), low birth weight (OR = 1. 32; 95% CI, 1.10 to 1.58), small-for-gestational age (OR = 1.26; 95% CI, 1.10 to 1.45), congenital anomalies (OR = 1.37; 95% CI, 1.12 to 1.68), and increased infant hospital length of stay (OR = 1.44; 95% CI, 1.25 to 1.65). The adverse maternal outcomes associated with maternal asthma were: pre-eclampsia (OR = 2.18; 95% CI, 1.68 to 2. 83), placenta previa (OR = 1.71; 95% CI, 1.05 to 2.79), cesarean delivery (OR = 1.62; 95% CI, 1.46 to 1.80), and increased maternal hospital length of stay (OR = 1.86; 95% CI, 1.60 to 2.15). The results emphasize the need for maternal asthma to be added to the list of conditions that increase the risk of adverse pregnancy outcomes.

摘要

我们采用历史队列分析法,对1989年至1992年间新泽西州医院的单胎活产情况(n = 447,963)进行研究,以探究婴儿和母亲的结局与妊娠合并哮喘之间的关系。通过将出生证明与母亲和新生儿的医院索赔数据相链接,确定了研究对象母婴对。将患有国际疾病分类第九版临床修订本(ICD - 9 - CM)哮喘诊断代码(493)的女性(n = 2,289)与从其余女性群体中随机抽取的四倍大的对照样本(n = 9,156)进行比较。在控制了重要混杂变量的影响后,母亲哮喘与以下不良婴儿结局相关:早产(比值比[OR] = 1.36;95%置信区间[CI],1.18至1.55)、低出生体重(OR = 1.32;95% CI,1.10至1.58)、小于胎龄儿(OR = 1.26;95% CI,1.10至1.45)、先天性异常(OR = 1.37;95% CI,1.12至1.68)以及婴儿住院时间延长(OR = 1.44;95% CI,1.25至1.65)。与母亲哮喘相关的不良母亲结局包括:先兆子痫(OR = 2.18;95% CI,1.68至2.83)、前置胎盘(OR = 1.71;95% CI,1.05至2.79)、剖宫产(OR = 1.62;95% CI,1.46至1.80)以及母亲住院时间延长(OR = 1.86;95% CI,1.60至2.15)。研究结果强调,有必要将母亲哮喘纳入增加不良妊娠结局风险的疾病清单中。

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