Mathis Collier, Pierre Hannoun, Valérie Cormier-Daire, Jean-Marc Treluyer, Alexandra Benachi, Eugénie Koumakis
{"title":"成骨不全症的妊娠相关并发症。","authors":"Mathis Collier, Pierre Hannoun, Valérie Cormier-Daire, Jean-Marc Treluyer, Alexandra Benachi, Eugénie Koumakis","doi":"10.1097/AOG.0000000000005957","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To evaluate obstetric and perinatal outcomes of pregnancies among patients with osteogenesis imperfecta using the French National Health Insurance Database.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study. Pregnancies were identified with an algorithm specifically developed for the French National Health Insurance Database to identify delivery stays using a combination of International Classification of Diseases, Tenth Revision (ICD-10) discharge codes and medical procedures. Exposure was osteogenesis imperfecta status based on the occurrence of ICD-10 code Q780 5 years before conception or during pregnancy. Outcomes included pregnancy, delivery, postpartum, and fetal complications based on hospital discharge data and reimbursements of medical procedures, medical devices, and drugs. Multivariable logistic regression analysis was performed, adjusted for multiple pregnancies per participant with generalized estimating equations.</p><p><strong>Results: </strong>The cohort included 8,850,969 pregnancies (5,823,322 patients) between January 2012 and December 2023. In total, 408 pregnant individuals (4.6/100,000) were identified with osteogenesis imperfecta. Compared with pregnant individuals without osteogenesis imperfecta, pregnant individuals with osteogenesis imperfecta had increased risks of antepartum hemorrhage (adjusted risk ratio [RR] 1.78, 95% CI, 1.01-3.14), chorioamnionitis (adjusted RR 2.79, 95% CI, 1.17-6.64), malpresentation (adjusted RR 1.65, 95% CI, 1.19-2.30), and preterm delivery (adjusted RR 2.11, 95% CI, 1.62-2.74). Cesarean delivery rates were notably higher in pregnant individuals with osteogenesis imperfecta (adjusted RR 2.59, 95% CI, 2.34-2.88), including among nulliparous individuals (adjusted RR 2.50, 95% CI, 2.22-2.81). Osteogenesis imperfecta was associated with major congenital anomalies (adjusted RR 5.04, 95% CI, 3.97-6.39 overall; adjusted RR 1.67, 95% CI, 1.09-2.56 when osteogenesis imperfecta was excluded from the congenital anomaly definition), especially cardiac anomalies. Postpartum analysis indicated no significant increase in fracture rates compared with prepregnancy periods.</p><p><strong>Conclusion: </strong>In this nationwide cohort study, osteogenesis imperfecta was associated with both maternal and fetal complications. These findings underscore the need for specialized, multidisciplinary management of pregnancies in patients with osteogenesis imperfecta.</p>","PeriodicalId":19483,"journal":{"name":"Obstetrics and gynecology","volume":" ","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Pregnancy-Related Complications in Osteogenesis Imperfecta.\",\"authors\":\"Mathis Collier, Pierre Hannoun, Valérie Cormier-Daire, Jean-Marc Treluyer, Alexandra Benachi, Eugénie Koumakis\",\"doi\":\"10.1097/AOG.0000000000005957\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To evaluate obstetric and perinatal outcomes of pregnancies among patients with osteogenesis imperfecta using the French National Health Insurance Database.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study. Pregnancies were identified with an algorithm specifically developed for the French National Health Insurance Database to identify delivery stays using a combination of International Classification of Diseases, Tenth Revision (ICD-10) discharge codes and medical procedures. Exposure was osteogenesis imperfecta status based on the occurrence of ICD-10 code Q780 5 years before conception or during pregnancy. Outcomes included pregnancy, delivery, postpartum, and fetal complications based on hospital discharge data and reimbursements of medical procedures, medical devices, and drugs. Multivariable logistic regression analysis was performed, adjusted for multiple pregnancies per participant with generalized estimating equations.</p><p><strong>Results: </strong>The cohort included 8,850,969 pregnancies (5,823,322 patients) between January 2012 and December 2023. In total, 408 pregnant individuals (4.6/100,000) were identified with osteogenesis imperfecta. Compared with pregnant individuals without osteogenesis imperfecta, pregnant individuals with osteogenesis imperfecta had increased risks of antepartum hemorrhage (adjusted risk ratio [RR] 1.78, 95% CI, 1.01-3.14), chorioamnionitis (adjusted RR 2.79, 95% CI, 1.17-6.64), malpresentation (adjusted RR 1.65, 95% CI, 1.19-2.30), and preterm delivery (adjusted RR 2.11, 95% CI, 1.62-2.74). Cesarean delivery rates were notably higher in pregnant individuals with osteogenesis imperfecta (adjusted RR 2.59, 95% CI, 2.34-2.88), including among nulliparous individuals (adjusted RR 2.50, 95% CI, 2.22-2.81). Osteogenesis imperfecta was associated with major congenital anomalies (adjusted RR 5.04, 95% CI, 3.97-6.39 overall; adjusted RR 1.67, 95% CI, 1.09-2.56 when osteogenesis imperfecta was excluded from the congenital anomaly definition), especially cardiac anomalies. Postpartum analysis indicated no significant increase in fracture rates compared with prepregnancy periods.</p><p><strong>Conclusion: </strong>In this nationwide cohort study, osteogenesis imperfecta was associated with both maternal and fetal complications. These findings underscore the need for specialized, multidisciplinary management of pregnancies in patients with osteogenesis imperfecta.</p>\",\"PeriodicalId\":19483,\"journal\":{\"name\":\"Obstetrics and gynecology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-07-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Obstetrics and gynecology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/AOG.0000000000005957\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Obstetrics and gynecology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/AOG.0000000000005957","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Pregnancy-Related Complications in Osteogenesis Imperfecta.
Objective: To evaluate obstetric and perinatal outcomes of pregnancies among patients with osteogenesis imperfecta using the French National Health Insurance Database.
Methods: We conducted a retrospective cohort study. Pregnancies were identified with an algorithm specifically developed for the French National Health Insurance Database to identify delivery stays using a combination of International Classification of Diseases, Tenth Revision (ICD-10) discharge codes and medical procedures. Exposure was osteogenesis imperfecta status based on the occurrence of ICD-10 code Q780 5 years before conception or during pregnancy. Outcomes included pregnancy, delivery, postpartum, and fetal complications based on hospital discharge data and reimbursements of medical procedures, medical devices, and drugs. Multivariable logistic regression analysis was performed, adjusted for multiple pregnancies per participant with generalized estimating equations.
Results: The cohort included 8,850,969 pregnancies (5,823,322 patients) between January 2012 and December 2023. In total, 408 pregnant individuals (4.6/100,000) were identified with osteogenesis imperfecta. Compared with pregnant individuals without osteogenesis imperfecta, pregnant individuals with osteogenesis imperfecta had increased risks of antepartum hemorrhage (adjusted risk ratio [RR] 1.78, 95% CI, 1.01-3.14), chorioamnionitis (adjusted RR 2.79, 95% CI, 1.17-6.64), malpresentation (adjusted RR 1.65, 95% CI, 1.19-2.30), and preterm delivery (adjusted RR 2.11, 95% CI, 1.62-2.74). Cesarean delivery rates were notably higher in pregnant individuals with osteogenesis imperfecta (adjusted RR 2.59, 95% CI, 2.34-2.88), including among nulliparous individuals (adjusted RR 2.50, 95% CI, 2.22-2.81). Osteogenesis imperfecta was associated with major congenital anomalies (adjusted RR 5.04, 95% CI, 3.97-6.39 overall; adjusted RR 1.67, 95% CI, 1.09-2.56 when osteogenesis imperfecta was excluded from the congenital anomaly definition), especially cardiac anomalies. Postpartum analysis indicated no significant increase in fracture rates compared with prepregnancy periods.
Conclusion: In this nationwide cohort study, osteogenesis imperfecta was associated with both maternal and fetal complications. These findings underscore the need for specialized, multidisciplinary management of pregnancies in patients with osteogenesis imperfecta.
期刊介绍:
"Obstetrics & Gynecology," affectionately known as "The Green Journal," is the official publication of the American College of Obstetricians and Gynecologists (ACOG). Since its inception in 1953, the journal has been dedicated to advancing the clinical practice of obstetrics and gynecology, as well as related fields. The journal's mission is to promote excellence in these areas by publishing a diverse range of articles that cover translational and clinical topics.
"Obstetrics & Gynecology" provides a platform for the dissemination of evidence-based research, clinical guidelines, and expert opinions that are essential for the continuous improvement of women's health care. The journal's content is designed to inform and educate obstetricians, gynecologists, and other healthcare professionals, ensuring that they stay abreast of the latest developments and best practices in their field.