A Retrospective Review of Social Deprivation Index and Maternal Outcomes with Placenta Accreta Spectrum from a Single Referral Center.
A Retrospective Review of Social Deprivation Index and Maternal Outcomes with Placenta Accreta Spectrum from a Single Referral Center.
复制标题
使用来自单一转诊中心的植入性胎盘谱对社会剥夺指数和孕产妇结局进行回顾性审查。
DOI：
10.1055/s-0043-1770162
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发表时间：
2023
影响因子：
2
通讯作者：
Aagaard,KjerstiM
中科院分区：
文献类型：
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作者：
Goulding,AlisonN;Fox,KarinA;Reed,ChristinaC;Salmanian,Bahram;Shamshirsaz,AlirezaA;Aagaard,KjerstiM
关于社区特征如何影响胎盘植入谱（PAS）的结果知之甚少。我们的目的是评估是否有不良的孕产妇结局与PAS交付在一个单一的转诊中心不同的社会deprivation.Study DesignWe进行了回顾性队列研究的单胎孕妇与组织病理学证实PAS交付从2011年1月至2021年6月在转诊中心。数据提取收集了相关的患者信息，包括居民邮政编码，这与社会剥夺指数（SDI）评分（一种衡量地区社会剥夺的指标）有关。将SDI评分分为四分位数进行分析。主要结局是母体不良结局的复合结局。双变量分析和多变量logistic regression performed.ResultsAmong我们的队列（n= 264），那些在最低（最少剥夺）SDI四分位数的年龄较大，有较低的体重指数，更有可能确定为非西班牙裔白色。81例（30.7%）发生复合母体不良结局，SDI四分位数无显著差异。生活在贫困地区的患者术中输注≥4个红细胞单位的发生率更高（最高[最贫困] SDI四分位数为31.2%，最低[最贫困] SDI四分位数为22.7%，p= 0.04）。SDI四分位数的其他结局无差异。在多变量logistic回归中，SDI增加四分位数与输血≥4个红细胞单位的几率增加32%相关（调整后的比值比：1.32，95%置信区间：结论在一个转诊中心分娩的PAS孕妇队列中，我们发现，那些生活在社会贫困社区的人更有可能接受≥4个红细胞单位的输血，但其他孕产妇不良结局没有差异。我们的研究结果强调了考虑周围社区的特征如何影响PAS结果的重要性，并可能有助于风险分层和资源部署。
ObjectiveLittle is known about how community characteristics influence placenta accreta spectrum (PAS) outcomes. Our objective was to evaluate whether adverse maternal outcomes among pregnant people (gravidae) with PAS delivering at a single referral center differ by community-level measures of social deprivation.Study DesignWe conducted a retrospective cohort study of singleton gravidae with histopathology confirmed PAS delivering from January 2011 to June 2021 at a referral center. Data abstraction collected relevant patient information, including resident zip code, which was linked to Social Deprivation Index (SDI) score (a measure of area-level social deprivation). SDI scores were divided into quartiles for analysis. Primary outcome was a composite of maternal adverse outcomes. Bivariate analyses and multivariable logistic regression were performed.ResultsAmong our cohort (n= 264), those in the lowest (least deprived) SDI quartile were older, had lower body mass index, and were more likely to identify as non-Hispanic white. Composite maternal adverse outcome occurred in 81 (30.7%), and did not differ significantly by SDI quartile. Intraoperative transfusion of ≥4 red blood cell units occurred more often among those living in deprived areas (31.2% in the highest [most deprived] vs. 22.7% in the lowest [least deprived] SDI quartile,p= 0.04). No other outcomes differed by SDI quartile. In multivariable logistic regression, a quartile increase in SDI was associated with 32% increased odds of transfusion of ≥4 red blood cell units (adjusted odds ratio: 1.32, 95% confidence interval: 1.01–1.75).ConclusionWithin a cohort of gravidae with PAS delivered at a single referral center, we found that those living in more socially deprived communities were more likely to receive transfusion of ≥4 red blood cell units, but other maternal adverse outcomes did not differ. Our findings highlight the importance of considering how characteristics of the surrounding community can impact PAS outcomes and may assist with risk stratification and resource deployment.Key Points