产后出血:早产与足月妊娠[ID: 1356883]

A. Whelan, Halie Ciomperlik, I. Ghose, H. Mendez-Figueroa, S. Wagner, R. Wiley
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引用次数: 0

摘要

简介:不像新生儿发病率与早产(PTB;37周)的综合产妇发病率(cmm -出血量>1,000 mL、子宫强张剂使用、输血、子宫填塞、手术干预、重症监护病房(ICU)入院、子宫切除术和产妇死亡)的主要结局。采用多变量回归评估CMM患者早产的调整相对危险度(aRR)。结果:在我们4级医院的4,554例分娩中,4,514例(99%)符合纳入标准,1,062例(23%)早产。总体CMM为23.2%,其中PTB为30.4%,足月为21.0%。控制年龄、体重指数大于30 kg/m2、无产、保险状况、种族、吸烟状况和剖宫产,早产的CMM发生率比足月分娩高42% (aRR 1.42: 95% CI, 1.27, 1.60)。输血、ICU住院和子宫切除术在PTB中比足月更常见。结论:早产与足月分娩相比,产后出血性CMM发生率显著升高。需要进行介入性试验以降低肺结核的出血性发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Postpartum Hemorrhage: Preterm Versus Term Pregnancies [ID: 1356883]
INTRODUCTION: Unlike neonatal morbidity with preterm birth (PTB; <37 weeks), maternal complications with PTB are infrequently reported. We aimed to assess the risk of postpartum hemorrhage (PPH)-related maternal morbidity among preterm versus term deliveries. METHODS: This was a secondary analysis of an IRB-approved retrospective cohort of all in-house singleton deliveries over 1 year. Demographics, pregnancy and delivery characteristics were abstracted from charts. Individuals who delivered preterm were compared to those who delivered at term (>37 weeks) for the primary outcome of composite maternal morbidity (CMM—blood loss >1,000 mL, uterotonic use, transfusion, uterine tamponade, surgical intervention, intensive care unit [ICU] admission, hysterectomy, and maternal death). Multivariable regression was performed to assess the adjusted relative risk (aRR) of preterm delivery on CMM with variables specified a priori. RESULTS: Of the 4,554 deliveries in our level 4 hospital, 4,514 (99%) met the inclusion criteria, with 1,062 (23%) delivering preterm. The overall CMM was 23.2%, with it being 30.4% in PTB and 21.0% in term births. Controlling for age, body mass index greater than 30 kg/m2, nulliparity, insurance status, race, smoking status, and cesarean delivery, preterm deliveries had a 42% higher rate of the CMM compared to term births (aRR 1.42: 95% CI, 1.27, 1.60). Transfusion, ICU admission, and hysterectomy were significantly more common among PTB than term. CONCLUSION: Preterm deliveries were associated with significantly higher rates of postpartum hemorrhagic CMM than those who delivered at term. Interventional trials are needed to decrease the hemorrhagic morbidity with PTB.
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