Pregnancy and Parity as Risk Factors for Recurrence in Idiopathic Subglottic Stenosis.

IF 2.6 3区医学 Q1 OTORHINOLARYNGOLOGY

Otolaryngology- Head and Neck Surgery Pub Date : 2025-04-10 DOI:10.1002/ohn.1255

Andrew S Awadallah, Forrest W Fearington, Yousuf H Khalil, Andrew J Bowen, Hawa M Ali, Yan Li, David O Francis, Seth H Dailey, Eric S Edell, Matthew J Koster, Semirra L Bayan, Dale C Ekbom

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引用次数: 0

Abstract

Objective: This study aims to evaluate the impact of parity on the severity and recurrence rates of idiopathic subglottic stenosis (iSGS) in premenopausal females.

Study design: A retrospective cohort study.

Setting: Two tertiary care centers from 2002 to 2024.

Methods: We analyzed premenopausal iSGS patients under 40 years who underwent balloon dilation or laser wedge excision. Clinical features, including demographics and pregnancy history, were examined. Recurrence rates between nulliparous and parous patients were compared using Poisson regression, adjusting for age and follow-up duration. Linear regression assessed the relationship between pregnancy and iSGS recurrence.

Results: Forty-eight patients were included, with 36 parous and 12 nulliparous. Adjusting for age and follow-up, the mean recurrence rate was 2.6 times higher in parous patients (95% confidence interval [CI]: [1.5, 4.8], P = .0008). Each additional pregnancy was associated with 0.81 additional recurrences (95% CI: [0.05, 1.57], P = .0375). No significant differences in surgery-free time were observed between groups.

Conclusion: Parity and pregnancy significantly increase the risk of iSGS recurrence, although they do not accelerate subsequent recurrences. Health care providers should counsel women of childbearing age about these risks in family planning discussions, emphasizing shared decision-making regarding potential surgical interventions.

Level of evidence: 3:

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妊娠和胎次是特发性声门下狭窄复发的危险因素。

目的：本研究旨在评估胎次对绝经前女性特发性声门下狭窄（iSGS）严重程度和复发率的影响。研究设计：回顾性队列研究。从2002年到2024年，两个三级护理中心。方法：我们分析了40岁以下接受球囊扩张或激光楔形切除术的绝经前iSGS患者。临床特征，包括人口统计学和妊娠史进行了检查。未产和已产患者的复发率采用泊松回归进行比较，调整年龄和随访时间。线性回归评估妊娠与iSGS复发的关系。结果：纳入48例患者，分娩36例，未分娩12例。经年龄和随访调整后，产妇的平均复发率是产妇的2.6倍（95%可信区间[CI]: [1.5, 4.8], P = 0.0008）。每增加一次妊娠与0.81例复发相关（95% CI: [0.05, 1.57], P = 0.0375）。两组间无手术时间无显著差异。结论：胎次和妊娠显著增加iSGS复发的风险，尽管它们不会加速随后的复发。卫生保健提供者应在计划生育讨论中就这些风险向育龄妇女提出建议，强调就可能的手术干预措施共同决策。证据等级：3；

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来源期刊

Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学

CiteScore

6.70

自引率

2.90%

发文量

250

审稿时长

2-4 weeks

期刊介绍： Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.