美国一家多学科产科/风湿病诊所的妊娠结果:五年回顾性分析

IF 3.7 2区 医学 Q1 RHEUMATOLOGY
Griffin Reed, Mery Deeb, Joyce Mathew, Kelsey Rigby, Elena Cravens, Christina Raker, Shadi Jafari-Esfahani, Anthony M Reginato, Gofran Tarabulsi, Joanne S Cunha
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引用次数: 0

摘要

目标:在罗德岛普罗维登斯的妇女与婴儿医院,妊娠期专科护理诊所将产科内科医生与风湿病学家联合起来,为患有风湿病的孕妇提供护理服务。这类诊所非常稀缺,在美国已知的类似诊所只有三家。本研究旨在了解该诊所护理人群的特点,确定干预措施,并分析母亲和新生儿的妊娠结局:方法:从 2016 年 1 月 1 日到 2021 年 12 月 31 日,进行了为期五年的回顾性病历审查:81名患者中,62%患有临床诊断的风湿性疾病。在 87 次就诊(包括孕前、产前和产后就诊)中,54% 的患者正在服用传统合成的改善病情抗风湿药物,17% 的患者正在服用生物改善病情抗风湿药物。52%的患者开始服用新药。52%的妊娠为活产,2%为流产。19%的新生儿出现早产,9%的新生儿出现宫内生长受限:我们的研究说明了多学科护理对产前和围产期风湿病患者的益处。产科内科医生和风湿免疫科医生的专业知识对于做出复杂的决定至关重要,他们需要权衡治疗的益处和对胎儿的潜在风险。我们的多学科方法使接受疾病调整疗法的患者人数翻了一番,并根据现行指南的建议,增加了羟氯喹和/或阿司匹林的预防治疗。更多此类多学科诊所将有助于协调经常治疗这些高风险、特殊患者的医生之间的护理工作,并为对这一研究不足的人群进行更多研究打开大门。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pregnancy Outcomes from a Multidisciplinary Obstetric-Medicine/Rheumatology Clinic in the United States: A Five-Year Retrospective Analysis.

Objective: At Women & Infants Hospital in Providence, Rhode Island, the Specialty Care in Pregnancy clinic combines obstetric-medicine internists with rheumatologists to care for pregnant patients with rheumatologic conditions. These clinics are scarce, with only three known similar clinics in the United States. This study aims to characterize the population cared for in this clinic, identify interventions, and analyze pregnancy outcomes for the birthing parents and newborns.

Methods: A five-year retrospective chart review was performed from January 1st, 2016, through December 31st, 2021.

Results: Of 81 patients, 62% had a clinically diagnosed rheumatic disorder. Of 87 patient visits, which included preconception, prenatal, and postpartum encounters, 54% of patients were taking conventional synthetic disease modifying antirheumatic drugs, and 17% were taking biologic disease modifying antirheumatic drugs. New medications were started in 52% of patients. A total of 52% of pregnancies resulted in live births, with 2% resulting in miscarriages. Prematurity occurred in 19% of newborns, and 9% had intrauterine growth restriction.

Conclusion: Our study illustrates the benefits of multidisciplinary care in patients with rheumatologic disorders during their prenatal and perinatal periods. The expertise from both the obstetric-medicine internists and rheumatologists was critical in making complex decisions that weighed the benefits of therapy against potential risks for the fetus. Our multidisciplinary approach resulted in doubling of the number of patients initiating disease modifying therapy and increased prophylaxis with hydroxychloroquine and/or aspirin therapy, as recommended by current guidelines. Additional multidisciplinary clinics of this type would help coordinate care among physicians who frequently treat these high-risk, unique patients and open the door for more research of this understudied population.

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来源期刊
CiteScore
9.40
自引率
6.40%
发文量
368
审稿时长
3-6 weeks
期刊介绍: Arthritis Care & Research, an official journal of the American College of Rheumatology and the Association of Rheumatology Health Professionals (a division of the College), is a peer-reviewed publication that publishes original research, review articles, and editorials that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with rheumatic diseases, major topics are evidence-based practice studies, clinical problems, practice guidelines, educational, social, and public health issues, health economics, health care policy, and future trends in rheumatology practice.
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