妊娠肺动脉高压患者的产科合并症指数（OB-CMI）及其与ICU住院和住院时间的关系：一项回顾性队列研究（1996-2025）

IF 2.3 3区医学 Q2 ANESTHESIOLOGY

International journal of obstetric anesthesia Pub Date : 2025-08-09 DOI:10.1016/j.ijoa.2025.104751

S. Ahmed , E. Liu , B. Eberhard , D. Villela-Franyutti , K. Gray , D. Drzymalski , V. Kovacheva

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引用次数: 0

摘要

妊娠期肺动脉高压与不良妊娠结局相关，如延长住院时间、入住重症监护病房（ICU）和高孕产妇死亡率。产科合并症指数（OB-CMI）评估这些结果的产妇风险；然而，其对肺动脉高压患者的预测能力尚不清楚。本研究评估了肺动脉高压患者的孕产妇和新生儿结局，并探讨了较高的合并症负担是否与更长时间的住院和ICU住院有关。方法回顾性队列研究采用麻省总医院布里格姆和塔夫茨医学中心1996 - 2025年7月的电子健康记录。使用国际疾病分类9/10代码确定肺动脉高压和妊娠超过20周的患者。采用手工图表复习法收集资料，进行描述性统计和单因素回归分析（P < 0.05）。结果61例患者中有65例妊娠。产妇年龄中位数为32.9岁（四分位数差为28.9-36.6岁）。产妇死亡率为3%，两例死亡都发生在2000年之前。大多数患者（56.9%）在硬膜外麻醉下剖宫产（69.2%）。中位OB-CMI为9，中位住院时间为6天。肺动脉压与住院时间延长（P = 0.004）和入住ICU （P = 0.027）相关。OB-CMI与ICU入院率呈临界相关（P = 0.046），与住院时间无显著相关性（P = 0.580）。结论肺动脉高压患者入住ICU和延长住院时间较常见，且与肺动脉压相关，但与OB-CMI无关。需要进一步研究开发针对肺动脉高压患者的评分工具，以改善风险评估。

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The Obstetric Comorbidity Index (OB-CMI) and its association with ICU admission and length of hospital stay in pregnant patients with pulmonary hypertension: a retrospective cohort study (1996–2025)

Background

Pulmonary hypertension in pregnancy is associated with adverse pregnancy outcomes, such as prolonged hospitalization, intensive care unit (ICU) admission, and high maternal mortality. The Obstetric Comorbidity Index (OB-CMI) assesses maternal risk for these outcomes; however, its predictive power in patients with pulmonary hypertension remains unknown. This study evaluates maternal and neonatal outcomes in patients with pulmonary hypertension and examines whether a higher comorbidity burden is associated with longer hospitalization and ICU admission.

Methods

A retrospective cohort study was conducted using electronic health records from Mass General Brigham and Tufts Medical Center (1996–July 2025). Patients with pulmonary hypertension and pregnancies beyond 20 weeks’ gestation were identified using the International Classification of Disease-9/10 codes. Data were collected via manual chart review, and descriptive statistics and univariate regression analyses were performed (P < 0.05).

Results

Sixty-five pregnancies among 61 patients were identified. The median maternal age was 32.9 (interquartile range 28.9–36.6) years. The maternal mortality rate was 3 %, with both deaths occurring before 2000. Most patients (56.9 %) had cesarean delivery under epidural anesthesia (69.2 %). Median OB-CMI was 9, and median hospitalization was 6 days. Pulmonary artery pressure was associated with prolonged hospitalization (P = 0.004) and ICU admission (P = 0.027). OB-CMI showed borderline association with ICU admission (P = 0.046), but not hospitalization duration (P = 0.580).

Conclusions

In patients with pulmonary hypertension, ICU admission and prolonged hospitalization were common and associated with pulmonary arterial pressure but not OB-CMI. Further studies are needed to develop scoring tools specific to pulmonary hypertension patients to improve risk assessment.

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来源期刊

International journal of obstetric anesthesia 医学-妇产科学

CiteScore

4.70

自引率

7.10%

发文量

285

审稿时长

58 days

期刊介绍： The International Journal of Obstetric Anesthesia is the only journal publishing original articles devoted exclusively to obstetric anesthesia and bringing together all three of its principal components; anesthesia care for operative delivery and the perioperative period, pain relief in labour and care of the critically ill obstetric patient. • Original research (both clinical and laboratory), short reports and case reports will be considered. • The journal also publishes invited review articles and debates on topical and controversial subjects in the area of obstetric anesthesia. • Articles on related topics such as perinatal physiology and pharmacology and all subjects of importance to obstetric anaesthetists/anesthesiologists are also welcome. The journal is peer-reviewed by international experts. Scholarship is stressed to include the focus on discovery, application of knowledge across fields, and informing the medical community. Through the peer-review process, we hope to attest to the quality of scholarships and guide the Journal to extend and transform knowledge in this important and expanding area.