Demographics, clinical characteristics and outcomes of neonates diagnosed with fetomaternal haemorrhage.
Demographics, clinical characteristics and outcomes of neonates diagnosed with fetomaternal haemorrhage.
复制标题
诊断为母胎出血的新生儿的人口统计、临床特征和结局。
DOI：
10.1136/archdischild-2011-300820
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发表时间：
2012
期刊：
影响因子：
--
通讯作者：
Trasande,Leonardo
中科院分区：
文献类型：
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作者：
Stroustrup,Annemarie;Trasande,Leonardo
目的确定临床特征，人口统计学和诊断为胎儿母体出血（FMH）的新生儿的短期结局。设计作者分析了1993年至2008年全国住院患者样本。诊断为FMH的单胎婴儿通过国际疾病分类（ICD-9）代码762.3确定。进行描述性，单变量和多变量回归分析，以确定全国每年的发病率FMH随着时间的推移，以及人口统计学和新生儿FMH的临床特征。FMH新生儿需要高强度护理：26.3%接受机械通气，22.4%接受血液制品输注，27.8%接受中心静脉置管。早产（OR 3.7）、胎盘早剥（OR 9.8）、脐带异常（OR 11.4）是FMH的危险因素。较高的患者收入与FMH诊断的可能性增加相关（OR 1.2），白人比少数民族更容易被诊断（OR 1.9）。在美国南部（OR 0.8与美国东北部）的诊断频率降低。结论FMH的诊断与显著的发病率以及区域，社会经济和种族差异有关。需要进一步的研究来区分诊断编码偏差和疾病的真正流行病学。这是第一份关于FMH社会经济和种族/民族差异的报告，这可能代表需要全国关注的检测差异。
ObjectiveTo determine clinical characteristics, demographics and short-term outcomes of neonates diagnosed with fetomaternal haemorrhage (FMH).DesignThe authors analysed the Nationwide Inpatient Sample, 1993 to 2008. Singleton births diagnosed with FMH were identified by International Classification of Diseases (ICD-9) code 762.3. Descriptive, univariate and multivariable regression analyses were performed to determine the national annual incidence of FMH over time as well as demographics and clinical characteristics of neonates with FMH.ResultsFMH was identified in 12 116 singleton births. Newborns with FMH required high intensity of care: 26.3% received mechanical ventilation, 22.4% received blood product transfusion and 27.8% underwent central line placement. Preterm birth (OR 3.7), placental abruption (OR 9.8) and umbilical cord anomaly (OR 11.4) were risk factors for FMH. Higher patient income was associated with increased likelihood of FMH diagnosis (OR 1.2), and Whites were more likely to be diagnosed than ethnic minorities (OR 1.9). There was reduced frequency of diagnosis in the Southern USA (OR 0.8 vs the Northeastern USA).ConclusionsDiagnosis of FMH is associated with significant morbidity as well as regional, socioeconomic and racial disparity. Further study is needed to distinguish between diagnostic coding bias and true epidemiology of the disease. This is the first report of socioeconomic and racial/ethnic disparities in FMH, which may represent disparities in detection that require national attention.