Concerning trends in maternal risk factors in the United States: 1989-2018.
Concerning trends in maternal risk factors in the United States: 1989-2018.
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DOI：
10.1016/j.eclinm.2020.100657
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发表时间：
2020-12
影响因子：
15.1
通讯作者：
Grünebaum A
中科院分区：
文献类型：
--
作者：
Bornstein E;Eliner Y;Chervenak FA;Grünebaum A
在美国，越来越多的努力侧重于降低孕产妇发病率和死亡率。妊娠期高血压疾病、慢性高血压、糖尿病、高龄产妇和多胎妊娠是导致各种产妇发病率和产妇死亡率的已知因素。我们旨在评估过去三十年（1989-2018）美国妊娠中这些风险因素/并发症的趋势。这是一项基于CDC出生率数据库的回顾性研究。我们计算了1989年至2018年期间每种风险因素/并发症的年患病率。然后使用联合点回归分析来评估趋势。计算了通过联合点回归确定的每个细分市场的年度百分比变化（APC），并计算了整个期间的平均年度百分比变化（AAPC）。还计算了2018年每种风险因素/并发症的患病率与1989年患病率的相对风险（RR）。随后的分析按产妇年龄组评价了主要风险因素/并发症的趋势。在p<0.05时确定统计学显著性，结果以95%置信区间表示。1989年至2018年间，妊娠期高血压疾病的患病率增加了149%（AAPC 3.2，95%CI 2.6 ~ 3.8），慢性高血压组增加182%（AAPC 3.7，95%CI 3.3 ~ 4.2），糖尿病组增加261%（AAPC 4.6，95%CI 4.0 - 5.2），高龄产妇的妊娠率增加了194%（AAPC 3.8，95%CI 3.6 - 4.0），大多产产妇的妊娠率增加了33%（AAPC 1.0，95%CI 0.8 - 1.2）。慢性高血压和糖尿病在过去二十年中主要增加，而妊娠高血压疾病和多胎妊娠主要在最近十年中增加。此外，在整个研究期间，高龄产妇的妊娠期高血压疾病、慢性高血压和糖尿病的发病率明显较高。我们的研究表明，在过去三十年（1989-2018年）中，五种怀孕风险因素/并发症的患病率显着增加。这可能表明美国孕妇的健康状况显著恶化，这可能导致孕产妇发病率和死亡率。一个也没有。
Increased efforts have focused on reducing maternal morbidity and mortality in the United States (US). Hypertensive disorders of pregnancy, chronic hypertension, diabetes mellitus, very advanced maternal age, and grand multiparity are known contributors to various maternal morbidities, as well as maternal mortality. We aimed to evaluate the trends in these risk factors/complications among US pregnancies during the last three decades (1989–2018). This is a retrospective study based on the CDC natality database. We calculated the annual prevalence of each risk factor/complication from 1989 to 2018. Joinpoint regression analysis was then used to evaluate the trends. Annual percentage changes (APC) were calculated for each of the segments identified by the joinpoint regression, and average annual percentage changes (AAPC) were calculated for the entire period. Relative risks (RR) comparing the prevalence of each risk factor/complication in 2018 to its prevalence in 1989 were also calculated. Subsequent analyses evaluated the trends of the main risk factors/complications by maternal age groups. Statistical significance was determined at p<0·05, and results were presented with 95% confidence intervals. Between 1989 and 2018, the prevalence of hypertensive disorders of pregnancy increased by 149% (AAPC 3·2, 95% CI 2·6–3·8), that of chronic hypertension increased by 182% (AAPC 3·7, 95% CI 3·3–4·2), that of diabetes mellitus increased by 261% (AAPC 4·6, 95% CI 4·0–5·2), that of very advanced maternal age increased by 194% (AAPC 3·8, 95% CI 3·6–4·0), and that of grand multiparity increased by 33% (AAPC 1·0, 95% CI 0·8–1·2). Chronic hypertension and diabetes mellitus increased mostly during the past two decades, while hypertensive disorders of pregnancy and grand multiparity increased primarily over the most recent decade. Additionally, women of very advanced maternal age had significantly higher rates of hypertensive disorders of pregnancy, chronic hypertension and diabetes mellitus throughout our study period. Our study shows a marked increase in the prevalence of five pregnancy risk factors/complications over the past three decades (1989–2018). This may point to a significant deterioration in the health of US pregnant women, which potentially contributes to both maternal morbidity and mortality. None.
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影响因子：
7.2
作者：
Jacobsson, B;Ladfors, L;Milsom, I
通讯作者：
Milsom, I
影响因子：
9.8
作者：
Bateman BT;Bansil P;Hernandez-Diaz S;Mhyre JM;Callaghan WM;Kuklina EV
通讯作者：
Kuklina EV
影响因子：
7.2
作者：
Berg, Cynthia J.;MacKay, Andrea R.;Callaghan, William M.
通讯作者：
Callaghan, William M.
DOI：
10.1111/j.1447-0756.2010.01476.x
发表时间：
2011-08-01
影响因子：
1.6
作者：
Agrawal, Smriti;Agarwal, Anjoo;Das, Vinita
通讯作者：
Das, Vinita
影响因子：
12.7
作者：
Fridman, Moshe;Korst, Lisa M.;Gregory, Kimberly D.
通讯作者：
Gregory, Kimberly D.