Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis.
Increased Rates of Obstetric Complications Prior to Systemic Sclerosis Diagnosis.
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DOI：
10.1002/acr.24533
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发表时间：
2022-06
影响因子：
4.7
通讯作者：
Chung L
中科院分区：
文献类型：
--
作者：
Chung MP;Kolstad KD;Dontsi M;Postlethwaite D;Manwani P;Zhao H;Kesh S;Simard JF;Chung L
调查系统性硬化症（SSc）诊断前的产科并发症是否比一般产科人群更常见。在Kaiser Permanente北方加州进行了一项病例对照研究，以比较2007-2016年期间后来发生SSc的成年女性（病例）与未发生SSc的普通产科人群女性（对照;按年龄和分娩年份匹配10：1）的既往产科并发症。暴露包括既往妊娠期高血压疾病（先兆子痫、子痫、妊娠期高血压）、胎膜早破（PROM）、宫内生长受限（IUGR）、母体感染、新生儿重症监护室（NICU）住院和早产。Fischer精确检验用于比较分类变量。条件Logistic回归模型估计了SSc结局的比值比（OR）和相应的95%置信区间。确定了17例SSc病例和170例非SSc对照，母亲分娩时的中位年龄为34岁（范围23-46岁），从分娩到SSc诊断的中位时间为2年（范围0.2-7.3年）。SSc病例更可能是西班牙裔和黑人。与对照组相比，最终诊断为SSc的妇女的既往产科并发症似乎更高（70.6% vs. 50%），包括高血压疾病（17.7% vs. 9.4%），PROM（11.8%对4.1%）、IUGR（5.9%对1.8%）、母体感染（29.4%对14.1%）、NICU入院（23.5%对7.7%）和早产（29.4%对21.8%）。病例分娩需要NICU的婴儿的几率较高（OR=4.7，95%CI 1.2-18.8）。最终发展为SSc的女性在明确诊断之前有更复杂的妊娠史的趋势。
To investigate whether obstetric complications prior to systemic sclerosis (SSc) diagnosis are more common compared to the general obstetric population. A case-control study was performed at Kaiser Permanente Northern California to compare prior obstetric complications in adult women who later developed SSc (cases) with women from the general obstetric population who did not develop SSc (controls; matched 10:1 by age and year of delivery) from 2007-2016. Exposures included past hypertensive disorders of pregnancy (preeclampsia, eclampsia, gestational hypertension), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), maternal infections, neonatal intensive care unit (NICU) admission, and preterm birth. Fischer’s exact tests were used to compare categorical variables. Conditional logistic regression models estimated the odds ratio (OR) and corresponding 95% confidence intervals for the outcome SSc. Seventeen SSc cases and 170 non-SSc controls were identified, with median maternal age at delivery 34 years (range 23-46 years) and median time from delivery to SSc diagnosis 2 years (range 0.2-7.3 years). SSc cases were more likely to be Hispanic and Black. Prior obstetric complications appeared higher in women with an eventual SSc diagnosis compared to controls (70.6% vs. 50%), including hypertensive disorders (17.7% vs. 9.4%), PROM (11.8% vs. 4.1%), IUGR (5.9% vs 1.8%), maternal infection (29.4% vs. 14.1%), NICU admissions (23.5% vs. 7.7%), and preterm delivery (29.4% vs. 21.8%). Cases had a higher odds of delivering infants requiring NICU admission (OR=4.7, 95% CI 1.2-18.8). Women who eventually develop SSc had trends towards more complicated pregnancy histories before overt diagnosis.
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影响因子：
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作者：
van den Hoogen, Frank;Khanna, Dinesh;Fransen, Jaap;Johnson, Sindhu R.;Baron, Murray;Tyndall, Alan;Matucci-Cerinic, Marco;Naden, Raymond P.;Medsger, Thomas A., Jr.;Carreira, Patricia E.;Riemekasten, Gabriela;Clements, Philip J.;Denton, Christopher P.;Distler, Oliver;Allanore, Yannick;Furst, Daniel E.;Gabrielli, Armando;Mayes, Maureen D.;van Laar, Jacob M.;Seibold, James R.;Czirjak, Laszlo;Steen, Virginia D.;Inanc, Murat;Kowal-Bielecka, Otylia;Mueller-Ladner, Ulf;Valentini, Gabriele;Veale, Douglas J.;Vonk, Madelon C.;Walker, Ulrich A.;Chung, Lorinda;Collier, David H.;Csuka, Mary Ellen;Fessler, Barri J.;Guiducci, Serena;Herrick, Ariane;Hsu, Vivien M.;Jimenez, Sergio;Kahaleh, Bashar;Merkel, Peter A.;Sierakowski, Stanislav;Silver, Richard M.;Simms, Robert W.;Varga, John;Pope, Janet E.
通讯作者：
Pope, Janet E.
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4.7
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Arkema, Elizabeth V.;Palmsten, Kristin;Simard, Julia F.
通讯作者：
Simard, Julia F.
影响因子：
168.9
作者：
Nelson, JL;Furst, DE;Bianchi, DW
通讯作者：
Bianchi, DW
影响因子：
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Chakravarty, Eliza F.;Khanna, Dinesh;Chung, Lorinda
通讯作者：
Chung, Lorinda
影响因子：
4.9
作者：
van Wyk L;van der Marel J;Schuerwegh AJ;Schouffoer AA;Voskuyl AE;Huizinga TW;Bianchi DW;Scherjon SA
通讯作者：
Scherjon SA