Assessing Pregnancy, Gestational Complications, and Co-morbidities in Women With Congenital Heart Defects (Data from ICD-9-CM Codes in 3 US Surveillance Sites).
Assessing Pregnancy, Gestational Complications, and Co-morbidities in Women With Congenital Heart Defects (Data from ICD-9-CM Codes in 3 US Surveillance Sites).
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评估先天性心脏缺陷女性的妊娠、妊娠并发症和合并症（数据来自美国 3 个监测站点的 ICD-9-CM 代码）。
DOI：
10.1016/j.amjcard.2019.12.001
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Book,WendyM
中科院分区：
文献类型：
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作者：
Raskind-Hood,Cheryl;Saraf,Anita;Riehle-Colarusso,Tiffany;Glidewell,Jill;Gurvitz,Michelle;Dunn,JulieE;Lui,GeorgeK;VanZutphen,Alissa;McGarry,Claire;Hogue,CarolJ;Hoffman,Trenton;RodriguezIii,FredH;Book,WendyM
先天性心脏病（CHD）治疗的改善使CHD妇女活到了生育年龄。然而，没有美国人口为基础的系统存在，以估计妊娠频率或并发症的妇女与冠心病。从3个监测点的多个数据源中确定了病例：埃默里大学（EU），其集水区包括亚特兰大5个大都市县;马萨诸塞州公共卫生部（MA），其集水区是全州范围;以及纽约州卫生部（NY），其集水区包括11个县。病例被分类为5个互斥的CHD严重程度组之一，分为重度和非重度;使用特定的ICD-9-CM代码来捕获11至50岁女性的妊娠、妊娠并发症和非妊娠合并症，并使用CHD相关ICD-9-CM代码。对妊娠、CHD严重程度、人口统计学、妊娠期并发症、合并症和保险状况进行评估。ICD-9-CM编码确定了26，655名患有CHD的女性，其中5，672名（21.3%，范围：纽约12.8%至MA 22.5%）有指示妊娠的编码。3年以上，重度CHD女性的年龄调整妊娠率为10.0%至24.6%，非重度CHD女性为14.2%至21.7%。与患有CHD的非妊娠女性相比，患有任何严重程度CHD的妊娠女性报告了更多的非心血管合并症。保险类型因地点和怀孕状况而异。这些基于美国人群的多中心CHD女性妊娠估计值表明，相当数量的CHD女性可能正在经历妊娠和并发症。总之，鉴于患有CHD的成年人口不断增长，患有CHD的妇女的生殖健康是一个重要的公共卫生问题。
Improved treatment of congenital heart defects (CHDs) has resulted in women with CHDs living to childbearing age. However, no US population-based systems exist to estimate pregnancy frequency or complications among women with CHDs. Cases were identified in multiple data sources from 3 surveillance sites: Emory University (EU) whose catchment area included 5 metropolitan Atlanta counties; Massachusetts Department of Public Health (MA) whose catchment area was statewide; and New York State Department of Health (NY) whose catchment area included 11 counties. Cases were categorized into one of 5 mutually exclusive CHD severity groups collapsed to severe versus not severe; specific ICD-9-CM codes were used to capture pregnancy, gestational complications, and nongestational co-morbidities in women, age 11 to 50 years, with a CHD-related ICD-9-CM code. Pregnancy, CHD severity, demographics, gestational complications, co-morbidities, and insurance status were evaluated. ICD-9-CM codes identified 26,655 women with CHDs, of whom 5,672 (21.3%, range: 12.8% in NY to 22.5% in MA) had codes indicating a pregnancy. Over 3 years, age-adjusted proportion pregnancy rates among women with severe CHDs ranged from 10.0% to 24.6%, and 14.2% to 21.7% for women with nonsevere CHDs. Pregnant women with CHDs of any severity, compared with nonpregnant women with CHDs, reported more noncardiovascular co-morbidities. Insurance type varied by site and pregnancy status. These US population-based, multisite estimates of pregnancy among women with CHD indicate a substantial number of women with CHDs may be experiencing pregnancy and complications. In conclusion, given the growing adult population with CHDs, reproductive health of women with CHD is an important public health issue.