Birth outcomes among women with congenital neuromuscular disabilities.
Birth outcomes among women with congenital neuromuscular disabilities.
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DOI：
10.1016/j.dhjo.2021.101259
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发表时间：
2022-04
影响因子：
4.5
通讯作者：
Werler MM
中科院分区：
文献类型：
--
作者：
Huezo García M;Parker SE;Petersen JM;Rubenstein E;Werler MM
残疾妇女面临不良分娩结果的风险增加；然而，对女性先天性神经肌肉残疾（cNMD）的研究是有限的。描述特征并比较有和没有cNMD的妇女的分娩结果。数据来自斯隆出生缺陷研究（1976-2015年进行的病例对照），该研究收集了人口、生殖和生活方式特征的信息。cNMD包括脊柱裂、脑瘫、肌肉萎缩、挛缩或关节挛缩，并由参与者报告确定。根据访谈年份和研究地点，将cNMD患者与非cNMD患者进行匹配。我们使用修正泊松回归来估计低出生体重、巨大儿、早产和胎龄小/大（SGA/LGA）的相对风险（RR）。考虑到病例对照设计和先天性异常婴儿的过度代表，对数据进行加权，以反映先天性异常婴儿的全国患病率为3%。患有cNMD的女性（n=125）更有可能是白人、无产、剖腹产、意外怀孕、孕前BMI≥25kg/m2、怀孕期间吸烟和泌尿生殖系统感染。与没有cNMD的妇女相比，患有cNMD的妇女的婴儿妊娠期较短（平均差：- 7.44天，95% CI: - 13.94, - 0.95）。cNMD与较高的早产风险（RR=3.98, 95% CI: 1.33, 11.95）和SGA （RR=2.14, 95% CI: 0.74, 6.15）相关。患有cNMD的女性更有可能早产并生出SGA婴儿。这些发现突出了cNMD妇女面临的差异，并强调需要提供最佳的围产期和生殖保健。
Women with disabilities are at an increased risk for adverse birth outcomes; however, research among women with congenital neuromuscular disabilities (cNMD) is limited. To describe characteristics and compare birth outcomes among women with and without cNMD. Data were from the Slone Birth Defects Study (case-control, conducted from 1976–2015), which collected information on demographic, reproductive, and lifestyle characteristics. cNMD included spina bifida, cerebral palsy, muscular dystrophy, contractures, or arthrogryposis and were identified by participant report. Those with cNMD were matched to participants without cNMD by interview year and study site. We use modified Poisson regression to estimate relative risks (RR) for low birthweight, macrosomia, preterm birth and small/large for gestational age (SGA/LGA). Given the case-control design and overrepresentation of infants with congenital anomalies, data were weighted to reflect a 3% national prevalence of infants with congenital anomalies. Women with cNMD (n=125) were more likely to be white, nulliparous, have a cesarean section, have an unplanned pregnancy, report a pre-pregnancy BMI ≥25kg/m2, smoke during pregnancy, and report genitourinary infections. Women with cNMD had infants with shorter gestational length (mean difference: −7.44 days, 95% CI: −13.94, −0.95) compared to women without cNMD. cNMD was associated with higher risk of preterm birth (RR=3.98, 95% CI: 1.33, 11.95) and SGA (RR=2.14, 95% CI: 0.74, 6.15). Women with cNMD were more likely to deliver preterm and have a SGA infant. These findings highlight disparities faced by women with cNMD and stress the need to provide optimal perinatal and reproductive care.
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