Risk factors for respiratory distress syndrome among high-risk early-term and full-term deliveries.
Risk factors for respiratory distress syndrome among high-risk early-term and full-term deliveries.
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DOI：
10.1080/14767058.2022.2128657
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发表时间：
2022-12
影响因子：
1.8
通讯作者：
Lewkowitz, Adam K.
中科院分区：
文献类型：
--
作者：
Gould, Alexander J.;Ding, Jia Jennifer;Recabo, Olivia;Has, Phinnara;Savitz, David A.;Danilack, Valery A.;Lewkowitz, Adam K.
关键词：
确定早产儿和足月产者呼吸窘迫综合征的危险因素是否不同。这是对 NIH 资助的一项大型回顾性队列研究的二次分析，研究对象包括 2002 年 1 月至 2013 年 3 月期间在三级产科医院分娩的患有糖尿病、高血压疾病和/或胎儿生长受限的患者。排除并发严重子痫前期和多胎妊娠的妊娠。母亲特征、分娩信息和新生儿信息是由训练有素的临床医生提取的，他们对合并症不知情，从而导致研究纳入。在对具有一种或多种合格条件的妊娠的婴儿健康结果的二次分析中，将早产新生儿（妊娠 37 周至 38 周 6 日）的呼吸窘迫综合征 (RDS) 风险与足月新生儿（39 周 0 日至 40 周 6 日）的 RDS 风险进行了比较。 10532例单胎新生儿中，早期RDS 99例（0.94%），足月RDS 95例（0.90%）。两组中患有和不患有 RDS 的母亲人口统计数据相似。在早产儿中，胎龄较低、胎便、非自然分娩和剖腹产与 RDS 呈正相关，而高血压、糖尿病、胎儿生长受限和许多其他共病分娩情况则不然。早产儿发生 RDS 的最强危险因素是剖腹产（RR 1.98，95% CI 1.31，3.01）。在足月新生儿中，剖宫产也与 RDS 呈正相关，尽管胎粪、绒毛膜羊膜炎和子宫内膜炎的存在都是更强的危险因素，RR > 2.0。在这个高风险分娩队列中，发现孕产妇人口统计数据和合并症与 RDS 风险增加无关，但在妊娠 37 周后发现了 RDS 的新危险因素——绒毛膜羊膜炎和子宫内膜炎。重点预防感染性合并症可能有助于降低足月 RDS 的发生率。
To identify whether risk factors for respiratory distress syndrome differ between early-term and full-term births. This is a secondary analysis of a large NIH-funded retrospective cohort study including patients who delivered at a tertiary-care obstetric hospital between January 2002 to March 2013 with comorbid diabetes, hypertensive disorders, and/or fetal growth restriction. Pregnancies complicated by severe preeclampsia and multifetal gestations were excluded. Maternal characteristics, delivery information, and neonatal information were abstracted by trained clinicians blinded to the comorbidity leading to study inclusion. In this secondary analysis of the infant health outcomes of pregnancies with one or more of the qualifying conditions, risk of respiratory distress syndrome (RDS) among neonates born early term (37w0d to 38w6d gestation) was compared to risk of RDS among full-term neonates (39w0d to 40w6d). Among 10,532 singleton newborns, there were 99 cases of early-term RDS (0.94%) and 95 cases of full-term RDS (0.90%). Maternal demographics were similar between those with and without RDS in both groups. Among early-term infants, lower gestational age, presence of meconium, non-spontaneous labor, and cesarean delivery were positively associated with RDS, whereas hypertensive disorders, diabetes, fetal growth restriction, and many other comorbid delivery conditions were not. The strongest risk factor for RDS among early-term infants was delivery via cesarean (RR 1.98, 95% CI 1.31, 3.01). Among full-term neonates, cesarean delivery was also positively associated with RDS, although presence of meconium, chorioamnionitis, and endometritis were all stronger risk factors with RRs > 2.0. In this cohort of high-risk deliveries, maternal demographics and comorbidities were found not to be associated with increased risk for RDS, but novel risk factors for RDS after 37 weeks’ gestation—chorioamnionitis and endometritis—were identified. A focus on preventing infectious comorbidities may help reduce incidence of RDS at full-term.
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影响因子：
2.9
作者：
Anadkat, J. S.;Kuzniewicz, M. W.;Chaudhari, B. P.;Cole, F. S.;Hamvas, A.
通讯作者：
Hamvas, A.
DOI：
10.1080/14767058.2016.1210597
发表时间：
2017-06-01
影响因子：
1.8
作者：
Condo, Valentina;Cipriani, Sonia;Mosca, Fabio
通讯作者：
Mosca, Fabio
影响因子：
9.8
作者：
Ghartey, Kobina;Coletta, Jaclyn;Gyamfi-Bannerman, Cynthia
通讯作者：
Gyamfi-Bannerman, Cynthia
DOI：
10.1097/ede.0000000000001442
发表时间：
2022-03-01
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Savitz DA;Danilack VA;Cochancela J;Hughes BL;Rouse DJ;Gutmann R
通讯作者：
Gutmann R
影响因子：
2.8
作者：
Gouyon, Jean-Bernard;Ribakovsky, C.;Gouyon, B.
通讯作者：
Gouyon, B.