Association of preconception paternal health on perinatal outcomes: analysis of US claims data
Association of preconception paternal health on perinatal outcomes: analysis of US claims data
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DOI：
10.1016/j.fertnstert.2019.12.026
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发表时间：
2020-05-01
影响因子：
6.7
通讯作者：
Eisenberg, Michael L.
中科院分区：
文献类型：
--
作者：
Kasman, Alex M.;Zhang, Chiyuan A.;Eisenberg, Michael L.
目的：评估父亲健康是否与孕产妇围产期和新生儿结局相关。设计：回顾性队列研究。地点：大学研究部门。患者：2009-2016 年间美国境内配对父亲和母亲所生子女的分析样本，覆盖活产。干预措施：父亲健康状况（例如，代谢综合征诊断、个体慢性病诊断）。主要结果测量：主要结局是早产（即 37 周前的活产），次要结局是低出生体重、新生儿重症监护病房 (NICU) 住院、妊娠糖尿病、先兆子痫、子痫和孕产妇死亡时间。结果：IBM Marketscan Research 数据库涵盖了通过就业资助的健康保险进行私人保险的住院和门诊患者的报销医疗保健索赔数据。我们评估了 785,809 名单胎活产婴儿，其中 6.6% 是早产儿。父亲合并症的存在与早产、低出生体重（LBW）和新生儿重症监护病房（NICU）住院的较高几率相关。调整母亲因素后，患有大部分或全部代谢综合征的父亲早产儿的几率高出 19%（95% CI 1.11-1.28），LBW 的几率高出 23%（95% CI 1.01-1.51），NICU 住院的几率高出 28%（95% CI 1.08-1.52）。孕产妇发病率（例如妊娠糖尿病或先兆子痫）也与孕前父亲健康呈正相关。结论：孕前父亲合并症的增加可能与婴儿和孕产妇的不良结局相关。尽管父亲的影响仍然不大，但这些发现强调了父母双方，尤其是母亲的健康对健康怀孕的重要性。 (C) 2019 年，美国生殖医学会。
Objective: To assess whether paternal health is associated with maternal peripartum and neonatal outcomes.Design: Retrospective cohort study.Setting: University research departments.Patient(s): Analytic sample of children born to paired fathers and mothers covering live births within the United States between 2009-2016.Intervention(s): Paternal health status (e.g., metabolic syndrome diagnoses, individual chronic disease diagnoses).Main Outcome Measure(s): Primary outcome of preterm birth (i.e., live birth before 37 weeks), and secondary outcomes of low birth weight, neonatal intensive care unit (NICU) stay, gestational diabetes, preeclampsia, eclampsia, and length of maternal slay.Result(s): The IBM Marketscan Research database covers reimbursed health care claims data on inpatient and outpatient encounters who are privately insured through employment-sponsored health insurance. We assessed 785,809 singleton live births, with 6.6% born preterm. The presence of paternal comorbidities was associated with higher odds of preterm birth, low birth weight (LBW), and NICU stay. After adjusting for maternal factors, fathers with most or all components of the metabolic syndrome had 19% higher odds of having a child born preterm (95% CI 1.11-1.28), 23% higher odds of LBW (95% CI 1.01-1.51), and 28% higher odds of NICU stay (95% CI 1.08-1.52). Maternal morbidity (e.g., gestational diabetes or preeclampsia) was also positively associated with preconception paternal health.Conclusion(s): Increased preconception paternal comorbidity may be associated with negative infant and maternal outcomes. Although the paternal effect remains modest, these findings highlight the importance of the health of both parents, particularly the mother, on healthy pregnancy. (C) 2019 by American Society for Reproductive Medicine.