成骨不全症的妊娠相关并发症。

IF 4.7 2区 医学 Q1 OBSTETRICS & GYNECOLOGY
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}
引用次数: 0

摘要

目的:利用法国国家健康保险数据库评估成骨不全患者妊娠的产科和围产期结局。方法:我们进行了一项回顾性队列研究。使用专门为法国国家健康保险数据库开发的一种算法确定妊娠,该算法结合《国际疾病分类第十版》(ICD-10)出院代码和医疗程序确定分娩停留时间。根据ICD-10代码Q780在受孕前5年或怀孕期间的发生情况,暴露为成骨不全状态。结果包括妊娠、分娩、产后和胎儿并发症,基于出院数据和医疗程序、医疗器械和药物的报销。进行了多变量logistic回归分析,并对每个参与者的多胎妊娠进行了广义估计方程调整。结果:该队列包括2012年1月至2023年12月期间的8,850,969例妊娠(5,823,322例患者)。共有408例孕妇(4.6/10万)被诊断为成骨不全。与没有成骨不全的孕妇相比,有成骨不全的孕妇产前出血(校正风险比[RR] 1.78, 95% CI, 1.01-3.14)、绒毛膜羊膜炎(校正风险比[RR] 2.79, 95% CI, 1.17-6.64)、胎儿畸形(校正风险比[RR] 1.65, 95% CI, 1.19-2.30)和早产(校正风险比[RR] 2.11, 95% CI, 1.62-2.74)的风险增加。成骨不全的孕妇剖宫产率明显较高(校正后RR为2.59,95% CI为2.34-2.88),包括未产孕妇(校正后RR为2.50,95% CI为2.22-2.81)。成骨不全与主要先天性异常相关(校正RR 5.04, 95% CI, 3.97-6.39;校正RR 1.67, 95% CI 1.09-2.56(排除成骨不全),尤其是心脏异常。产后分析显示,与孕前相比,骨折率没有明显增加。结论:在这项全国性队列研究中,成骨不全与母体和胎儿并发症有关。这些发现强调了对成骨不全患者妊娠进行专业化、多学科管理的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Obstetrics and gynecology
Obstetrics and gynecology 医学-妇产科学
CiteScore
11.10
自引率
4.20%
发文量
867
审稿时长
1 months
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信