Pregnancy and Neonatal Outcomes Among Deaf and Hard of Hearing Women: Results From Nationally Representative Data.
Pregnancy and Neonatal Outcomes Among Deaf and Hard of Hearing Women: Results From Nationally Representative Data.
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DOI：
10.1016/j.whi.2021.03.005
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发表时间：
2021-09
期刊：
影响因子：
--
通讯作者：
Valentine AM
中科院分区：
文献类型：
--
作者：
Mitra M;McKee MM;Akobirshoev I;Ritter GA;Valentine AM
尽管文献表明残疾妇女面临妊娠并发症和不良分娩结局的风险，但针对美国聋哑和听力障碍 (DHH) 妇女妊娠结局的基于人群的研究却很少。使用国家住院出院记录数据比较 DHH 和非 DHH 妇女分娩时的妊娠并发症和新生儿结局。我们使用 2007-2016 年医疗保健成本和利用项目全国住院患者样本，使用双变量和泊松回归比较 DHH 女性分娩与非 DHH 女性分娩的妊娠并发症和结局，并控制社会人口统计学、医院和临床特征。 DHH 女性出现不良妊娠结局和慢性疾病的风险增加，包括既往患有糖尿病（相对风险 [RR]，2.01；95% 置信区间，1.68–2.42；p < .001）、妊娠糖尿病（RR，1.31；95% CI，1.19–1.44；p < .001）、慢性高血压（RR，1.51；p < .001）。 95% CI, 1.33–1.72; p < .001)、先兆子痫和子痫 (RR, 1.35; 95% CI, 1.21–1.51; p < .01)、前置胎盘 (RR, 1.62; 95% CI, 1.22–2.16; p < .01)、胎盘早剥 (RR, 1.43；95% 置信区间，1.15–1.78；p < .01），引产（RR，1.16；95% CI，1.05–1.27；p < .01），绒毛膜羊膜炎（RR，1.43；95% CI，1.22–1.69；p < .001），剖宫产（RR， 1.09；95% CI，1.04–1.14；p < .001），胎膜早破（RR，1.34；95% CI，1.20–1.50；p < .001），产前出血（RR，1.36；95% CI，1.13–1.64；p < .001），以及产后出血（RR，1.30；95% CI，1.13–1.49；p < .001）。在调整社会经济和医院特征后，妊娠糖尿病、先兆子痫和子痫、前置胎盘和绒毛膜羊膜炎的风险仍然无法解释。 DHH 妇女出现不良妊娠、胎儿和新生儿结局的风险增加，这说明产科和初级保健提供者需要提高认识，以及对结局和循证指南进行系统调查的必要性。
Although the literature suggests that women with disabilities are at risk for pregnancy complications and adverse birth outcomes, there are few population-based studies of the pregnancy outcomes among deaf and hard of hearing (DHH) women in the United States. To compare pregnancy complications and neonatal outcomes between deliveries to DHH and non-DHH women using national hospitalization discharge record data. We used the 2007–2016 Healthcare Cost and Utilization Project National Inpatient Sample to compare pregnancy complications and outcomes among deliveries to DHH women with deliveries to non-DHH women using bivariate and Poisson regressions, controlling for sociodemographic, hospital, and clinical characteristics. DHH women had an increased risk of adverse pregnancy outcomes and chronic medical conditions, including preexisting diabetes (relative risk [RR], 2.01; 95% confidence interval, 1.68–2.42; p < .001), gestational diabetes (RR, 1.31; 95% CI, 1.19–1.44; p < .001), chronic hypertension (RR, 1.51; 95% CI, 1.33–1.72; p < .001), preeclampsia and eclampsia (RR, 1.35; 95% CI, 1.21–1.51; p < .01), placenta previa (RR, 1.62; 95% CI, 1.22–2.16; p < .01), placental abruption (RR, 1.43; 95% confidence interval, 1.15–1.78; p < .01), labor induction (RR, 1.16; 95% CI, 1.05–1.27; p < .01), chorioamnionitis (RR, 1.43; 95% CI, 1.22–1.69; p < .001), cesarean delivery (RR, 1.09; 95% CI, 1.04–1.14; p < .001), premature rupture of membranes (RR, 1.34; 95% CI, 1.20–1.50; p < .001), antepartum hemorrhage (RR, 1.36; 95% CI, 1.13–1.64; p < .001), and postpartum hemorrhage (RR, 1.30; 95% CI, 1.13–1.49; p < .001). After adjustment for socioeconomic and hospital characteristics, the risk for gestational diabetes, preeclampsia and eclampsia, placenta previa, and chorioamnionitis remained unexplained. DHH women are at an increased risk for adverse pregnancy, fetal, and neonatal outcomes, illuminating the need for awareness among obstetric and primary care providers as well as the need for systematic investigation of outcomes and evidence-based guidelines.
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影响因子：
7.6
作者：
BARON, RM;KENNY, DA
通讯作者：
KENNY, DA
DOI：
10.1111/1471-0528.14120
发表时间：
2016-04-01
影响因子：
5.8
作者：
Brown, H. K.;Speechley, K. N.;Campbell, M. K.
通讯作者：
Campbell, M. K.
影响因子：
3
作者：
Elixhauser, A;Steiner, C;Coffey, RN
通讯作者：
Coffey, RN
影响因子：
6.3
作者：
Cruickshanks KJ;Nondahl DM;Dalton DS;Fischer ME;Klein BE;Klein R;Nieto FJ;Schubert CR;Tweed TS
通讯作者：
Tweed TS
影响因子：
6.3
作者：
Genther DJ;Betz J;Pratt S;Martin KR;Harris TB;Satterfield S;Bauer DC;Newman AB;Simonsick EM;Lin FR;Health, Aging and Body Composition Study
通讯作者：
Health, Aging and Body Composition Study