Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study.
Maternal multimorbidity and preterm birth in Scotland: an observational record-linkage study.
复制标题
DOI：
10.1186/s12916-023-03058-4
复制
发表时间：
2023-09-12
期刊：
影响因子：
9.3
通讯作者：
Mccowan, Colin
中科院分区：
文献类型：
--
作者：
Azcoaga-Lorenzo, Amaya;Fagbamigbe, Adeniyi Francis;Agrawal, Utkarsh;Black, Mairead;Usman, Muhammad;Lee, Siang Ing;Eastwood, Kelly-Ann;Moss, Ngawai;Plachcinski, Rachel;Nelson-Piercy, Catherine;Brophy, Sinead;O'Reilly, Dermot;Nirantharakumar, Krishnarajah;Mccowan, Colin
在女性的整个生命过程中，多次死亡是很常见的。早产是新生儿死亡和发病的最大原因。我们的目的是估计孕妇中多发性骨髓瘤的患病率，并研究孕产妇多发性骨髓瘤和PTB之间的关系。这是一项回顾性队列研究，使用来自苏格兰Moreover Records的电子健康记录。纳入了所有年龄在15至49岁之间，受孕日期在2014年1月1日至2018年12月31日之间的怀孕妇女。多重死亡被定义为存在两种或两种以上预先存在的长期身体或精神健康状况，复杂多重死亡被定义为存在四种或四种以上。它是在受孕时使用MuM-PreDiCT联盟发布的79种条件的预定义列表计算的。PTB定义为妊娠24周至37周以内的活产婴儿。我们使用广义估计方程调整产妇年龄，社会经济地位，以前怀孕的次数，BMI和吸烟史，以估计产妇预先存在的多发病的影响。结果和表格中报告绝对比率，同时调整比值比（OR）（aOR）。来自27,711名孕妇的3557例单胎分娩被纳入分析。既存多发性骨髓瘤和复杂多发性骨髓瘤的患病率分别为16.8%（95% CI：16.4-17.2）和3.6%（95% CI：3.3-3.8）。最年轻年龄组的多发病率为10.2%（95%CI：8.8-11.6），而40 - 44岁年龄组为21.4%（95%CI：18.4-24.4），45 - 49岁年龄组为20%（95%CI：8.9-31.1）。在没有多发性骨髓瘤的妇女中，PTB的患病率为6.7%;多发性骨髓瘤妇女为11.6%，复杂多发性骨髓瘤妇女为15.6%。在调整了母亲年龄、社会经济状况、既往妊娠次数、体重指数（BMI）和吸烟情况后，多胎妊娠与PTB的更高几率相关（aOR = 1.64，95%CI：1.48-1.82）。六分之一的妇女在受孕时患有多胎妊娠，这与早产风险增加有关。多次死亡给妇女及其子女带来了沉重的健康负担。迫切需要对妊娠前和妊娠期间患有多发性硬化症的妇女进行常规和全面的评估。在线版本包含补充材料，可通过10.1186/s12916-023-03058-4获得。
Multimorbidity is common in women across the life course. Preterm birth is the single biggest cause of neonatal mortality and morbidity. We aim to estimate the prevalence of multimorbidity in pregnant women and to examine the association between maternal multimorbidity and PTB. This is a retrospective cohort study using electronic health records from the Scottish Morbidity Records. All pregnancies among women aged 15 to 49 with a conception date between 1 January 2014 and 31 December 2018 were included. Multimorbidity was defined as the presence of two or more pre-existing long-term physical or mental health conditions, and complex multimorbidity as the presence of four or more. It was calculated at the time of conception using a predefined list of 79 conditions published by the MuM-PreDiCT consortium. PTB was defined as babies born alive between 24 and less than 37 completed weeks of gestation. We used Generalised Estimating Equations adjusted for maternal age, socioeconomic status, number of previous pregnancies, BMI, and smoking history to estimate the effect of maternal pre-existing multimorbidity. Absolut rates are reported in the results and tables, whilst Odds Ratios (ORs) are adjusted (aOR). Thirty thousand five hundred fifty-seven singleton births from 27,711 pregnant women were included in the analysis. The prevalence of pre-existing multimorbidity and complex multimorbidity was 16.8% (95% CI: 16.4–17.2) and 3.6% (95% CI: 3.3–3.8), respectively. The prevalence of multimorbidity in the youngest age group was 10.2%(95% CI: 8.8–11.6), while in those 40 to 44, it was 21.4% (95% CI: 18.4–24.4), and in the 45 to 49 age group, it was 20% (95% CI: 8.9–31.1). In women without multimorbidity, the prevalence of PTB was 6.7%; it was 11.6% in women with multimorbidity and 15.6% in women with complex multimorbidity. After adjusting for maternal age, socioeconomic status, number of previous pregnancies, Body Mass Index (BMI), and smoking, multimorbidity was associated with higher odds of PTB (aOR = 1.64, 95% CI: 1.48–1.82). Multimorbidity at the time of conception was present in one in six women and was associated with an increased risk of preterm birth. Multimorbidity presents a significant health burden to women and their offspring. Routine and comprehensive evaluation of women with multimorbidity before and during pregnancy is urgently needed. The online version contains supplementary material available at 10.1186/s12916-023-03058-4.
登录
查看更多内容
影响因子：
168.9
作者：
Liu, Li;Johnson, Hope L.;Black, Robert E.
通讯作者：
Black, Robert E.
DOI：
10.1111/1471-0528.17291
发表时间：
2023-01
影响因子：
5.8
作者：
Aughey, Harriet;Jardine, Jennifer;Knight, Hannah;Gurol-Urganci, Ipek;Walker, Kate;Harris, Tina;van der Meulen, Jan;Hawdon, Jane;Pasupathy, Dharmintra
通讯作者：
Pasupathy, Dharmintra
影响因子：
3.1
作者：
Kersten, Ines;Lange, Anja Erika;Thyrian, Jochen Rene
通讯作者：
Thyrian, Jochen Rene
影响因子：
--
作者：
Haas, JS;Fuentes-Afflick, E;Escobar, GJ
通讯作者：
Escobar, GJ
影响因子：
7.2
作者：
Admon, Lindsay K.;Winkelman, Tyler N. A.;Dalton, Vanessa K.
通讯作者：
Dalton, Vanessa K.