Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease
Maternal and Fetal Outcomes of Admission for Delivery in Women With Congenital Heart Disease
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DOI：
10.1001/jamacardio.2017.0283
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发表时间：
2017-06-01
期刊：
影响因子：
24
通讯作者：
Tseng, Zian H.
中科院分区：
文献类型：
--
作者：
Hayward, Robert M.;Foster, Elyse;Tseng, Zian H.
背景：患有先天性心脏病（CHD）的妇女在妊娠和分娩期间发生不良事件的风险可能增加。这项回顾性研究的住院分娩入院的医疗保健成本和利用项目的加州国家住院病人数据库比较母亲和胎儿的结果之间有和没有冠心病使用多变量逻辑回归纳入了2005年1月1日至2011年12月31日国际疾病分类第九次修订版中分娩编码的女性患者。CHD与再入院的相关性在分娩后7年进行评估。心血管疾病的发病率和死亡率被认为在女性冠心病患者中更高。数据分析从2014年4月4日至2017年1月23日。暴露非复杂性和复杂性CHD。主要结局和指标产妇结局包括院内心律失常、子痫或先兆子痫、充血性心力衰竭（CHF）、住院时间、早产、妊娠合并贫血、胎盘异常、分娩期间感染、1年产妇再入院和院内死亡率。结果在3642041例确诊的分娩入院中，3189例为非复杂性CHD（平均[SD]年龄28.6 [7.6]岁），262例为复杂性CHD（平均[SD]年龄26.5 [6.8]岁）。有冠心病的妇女更容易接受剖宫产（1357例[39.3%] vs无冠心病的妇女1164509例[32.0%]; P
BACKGROUND Women with congenital heart disease (CHD) may be at increased risk for adverse events during pregnancy and delivery.OBJECTIVE To compare delivery outcomes between women with and without CHD.DESIGN, SETTING, AND PARTICIPANTS This retrospective study of inpatient delivery admissions in the Healthcare Cost and Utilization Project's California State Inpatient Database compared maternal and fetal outcomes between women with and without CHD by using multivariate logistic regression. Female patients with codes for delivery from the International Classification of Diseases, Ninth Revision, from January 1, 2005, through December 31, 2011, were included. The association of CHD with readmission was assessed to 7 years after delivery. Cardiovascular morbidity and mortality were hypothesized to be higher among women with CHD. Data were analyzed from April 4, 2014, through January 23, 2017.EXPOSURES Noncomplex and complex CHD.MAIN OUTCOMES AND MEASURES Maternal outcomes included in-hospital arrhythmias, eclampsia or preeclampsia, congestive heart failure (CHF), length of stay, preterm labor, anemia complicating pregnancy, placental abnormalities, infection during labor, maternal readmission at 1 year, and in-hospital mortality. Fetal outcomes included growth restriction, distress, and death.RESULTS Among 3 642 041 identified delivery admissions, 3189 women had noncomplex CHD (mean [SD] age, 28.6 [7.6] years) and 262 had complex CHD (mean [SD] age, 26.5 [6.8] years). Women with CHD were more likely to undergo cesarean delivery (1357 [39.3%] vs 1 164 509 women without CHD [32.0%]; P