结核病孕妇的临床特征和妊娠结局:一项回顾性队列研究。

IF 4.9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Jiayu Wen,Jian-Qing He
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引用次数: 0

摘要

目的:有关妊娠对结核病(TB)影响的研究还不多。方法 我们回顾性分析了 2011 年至 2022 年期间华西医院收治的妊娠期或产后 6 个月内患有活动性肺结核的妇女的病历。结果妊娠组和非妊娠组均为女性,平均年龄 26 岁,汉族占多数(分别为 72.4% 和 69.5%)。两组数据具有可比性(P < .05)。与非孕期病例相比,孕期肺结核病例出现发热(61% 对 35%)、呼吸困难(39.9% 对 18.7%)、神经症状(34.4% 对 11.0%)和粟粒性肺结核(24.5% 对 10.9%)的比例更高(P < .05)。此外,孕妇组的红细胞计数较低(3.62 × 109/L vs. 4.37 × 109/L),白蛋白水平较低(31.20 g/L vs. 40.40 g/L),炎症指标升高(P < .05)。患结核病的孕妇病情严重,16.3%的孕妇需要重症监护室(ICU)治疗,3.3%的孕妇死于结核病,高于当地平均水平。相比之下,非孕妇组的发病率较低(0.8%的孕妇需要入住重症监护室,无结核病相关死亡病例)。此外,妊娠期活动性肺结核导致自然流产率较高(34.1%),军事肺结核被确定为妊娠期严重肺结核的唯一风险因素(OR:3.6;95% CI:1.15,11.34)。妊娠合并活动性肺结核会对母亲和胎儿造成极大的伤害,今后需要特别关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clinical characteristics and pregnancy outcomes in pregnant women with TB: a retrospective cohort study.
PURPOSE The influence of pregnancy on tuberculosis (TB) has not been well studied. This study aimed to investigate the demographics, clinical characteristics and outcomes of pregnant-related TB compared with the general population with TB. METHODS We retrospectively analysed medical records of women during pregnancy or within six months postpartum with active TB who were admitted to the West China Hospital between 2011 and 2022. According to age, gender and admission time, the general population with active TB was matched at a ratio of 1:2, and the demographics, clinical characteristics and outcomes were compared. RESULTS All the participants in both the pregnant and non-pregnant groups were females, averaging 26 years old, with a majority of Han nationality (72.4% vs. 69.5%, respectively). The two groups were comparable (p < .05). Pregnant TB cases showed higher rates of fever (61% vs. 35%), dyspnoea (39.9% vs. 18.7%), neurological symptoms (34.4% vs. 11.0%) and miliary TB (24.5% vs. 10.9%) compared to non-pregnant cases (p < .05). Additionally, the pregnant group exhibited lower red blood cell counts (3.62 × 109/L vs. 4.37 × 109/L), lower albumin levels (31.20 g/L vs. 40.40 g/L) and elevated inflammatory markers (p < .05). Pregnant women with TB had severe outcomes, with 16.3% requiring intensive care unit (ICU) care and a 3.3% TB-related mortality rate - higher than local averages. In contrast, the non-pregnant group had lower rates (0.8% for ICU admission, and no TB-related deaths). Moreover, active TB during pregnancies led to a high rate of spontaneous abortion (34.1%), with military pulmonary TB identified as the sole risk factor for severe TB in pregnancies (OR: 3.6; 95% CI: 1.15, 11.34). CONCLUSIONS Manifestations of TB in pregnant women differ from those in the general population with TB. Pregnancy complicated with active TB greatly harms the mother and foetus and requires special attention in the future.
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来源期刊
Annals of medicine
Annals of medicine 医学-医学:内科
CiteScore
4.90
自引率
0.00%
发文量
292
审稿时长
3 months
期刊介绍: Annals of Medicine is one of the world’s leading general medical review journals, boasting an impact factor of 5.435. It presents high-quality topical review articles, commissioned by the Editors and Editorial Committee, as well as original articles. The journal provides the current opinion on recent developments across the major medical specialties, with a particular focus on internal medicine. The peer-reviewed content of the journal keeps readers updated on the latest advances in the understanding of the pathogenesis of diseases, and in how molecular medicine and genetics can be applied in daily clinical practice.
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