产妇医疗状况对初次剖宫产风险的综合影响。

IF 0.8 Q4 PEDIATRICS
AJP Reports Pub Date : 2024-01-23 eCollection Date: 2024-01-01 DOI:10.1055/s-0043-1777996
Robert Fresch, Kendal Stephens, Emily DeFranco
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引用次数: 0

摘要

背景常见的产妇合并症,如高血压疾病、糖尿病、吸烟,以及产妇年龄、体重指数和妊娠体重增加的极端情况,都会单独影响剖宫产率。许多研究已经估算了个别情况对剖宫产的风险。目的 研究患有多种产妇合并症的产妇的初次剖宫产风险,以确定这些合并症对分娩方式造成的累积风险。研究设计 在这项基于人群的回顾性队列研究中,我们分析了 2006 年至 2015 年俄亥俄州的活产记录数据,以估计单个和组合的产妇合并症对单胎初次剖宫产率的影响。暴露是指孕产妇个体和组合的医疗状况(慢性高血压[CHTN]、妊娠高血压、妊娠前糖尿病、妊娠糖尿病、吸烟、高龄产妇和孕产妇肥胖),结果是指原发性剖宫产率和调整后相对风险(aRR)。结果 在研究期间,俄亥俄州共有 1,463,506 例活产,其中 882,423 例(60.3%)的产妇患有一种或多种疾病,其中 243,112 例(27.6%)为初次剖宫产。在只有一种病症的单胎妊娠中,初次剖宫产率和 aRR 的范围为 13.9%至 29.3%(aRR 0.78-1.68),而在有多种并发症的妊娠中,初次剖宫产率和 aRR 的范围增加到 21.9%至 48.6%(aRR 1.34-3.87)。高龄产妇、患有妊娠前糖尿病的肥胖妇女和 CHTN 孕妇的初次剖宫产风险最高。结论 孕期合并症越多,初次剖宫产的累积风险越高。这些数据可能有助于向患者提供有关孕期剖宫产风险的咨询。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The Combined Influence of Maternal Medical Conditions on the Risk of Primary Cesarean Delivery.

Background  Common maternal medical comorbidities such as hypertensive disorders, diabetes, tobacco use, and extremes of maternal age, body mass index, and gestational weight gain are known individually to influence the rate of cesarean delivery. Numerous studies have estimated the risk of individual conditions on cesarean delivery. Objective  To examine the risk for primary cesarean delivery in women with multiple maternal medical comorbidities to determine the cumulative risk they pose on mode of delivery. Study Design  In this population-based retrospective cohort study, we analyzed data from Ohio live birth records from 2006 to 2015 to estimate the influence of individual and combinations of maternal comorbidities on rates of singleton primary cesarean delivery. The exposures were individual and combinations of maternal medical conditions (chronic hypertension [CHTN], gestational hypertension, pregestational diabetes, gestational diabetes, tobacco use, advanced maternal age, and maternal obesity) and outcomes were rates and adjusted relative risk (aRR) of primary cesarean delivery. Results  There were 1,463,506 live births in Ohio during the study period, of which 882,423 (60.3%) had one or more maternal medical condition, and of those 243,112 (27.6%) had primary cesarean delivery. The range of rates and aRR range of primary cesarean delivery were 13.9 to 29.3% (aRR 0.78-1.68) in singleton pregnancies with a single medical condition, and this increased to 21.9 to 48.6% (aRR 1.34-3.87) in pregnancies complicated by multiple medical comorbidities. The highest risk for primary cesarean occurred in advanced maternal age, obese women with pregestational diabetes, and CHTN. Conclusion  A greater number of maternal medical comorbidities during pregnancy is associated with increasing cumulative risk of primary cesarean delivery. These data may be useful in counseling patients on risk of cesarean during pregnancy.

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来源期刊
AJP Reports
AJP Reports PEDIATRICS-
CiteScore
2.20
自引率
0.00%
发文量
30
审稿时长
12 weeks
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