Pregnancy outcomes of a joint obstetric and rheumatology clinic in a tertiary centre: a 2-year retrospective study of 98 pregnancies.
Pregnancy outcomes of a joint obstetric and rheumatology clinic in a tertiary centre: a 2-year retrospective study of 98 pregnancies.
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DOI：
10.1093/rap/rkac026
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发表时间：
2022
影响因子：
3.1
通讯作者：
Ho, Pauline
中科院分区：
文献类型：
--
作者：
Hum, Ryan Malcolm;David, Trixy;Lau, Yen June;Iftikhar, Hajira;Thornber, Sue;Simcox, Louise;Bruce, Ian;Tower, Clare;Ho, Pauline
本研究的目的是描述在英国风湿病和产科联合诊所就诊的炎症性风湿病患者的孕产妇和胎儿结局。分析了2018年1月至2020年1月期间参加联合风湿病和产科诊所的98名患者的电子记录。将患者人口统计学、特征（包括年龄、种族、诊断和妊娠期间使用的药物）、妊娠结局（流产、死产或活产）、母体并发症[感染、产后出血（PPH）或先兆子痫]和胎儿并发症（败血症、先天性心脏传导阻滞、早产和低出生体重）的数据制表。以类似的方式描述了基于母体诊断、药物和Ro/La抗体状态的患者亚组。发现该队列主要是诊断为CTD的>30岁的白人女性。在98例妊娠中，97%（n = 95）导致活产，仅2%导致流产（n = 2），1%导致死产（n = 1）。中位妊娠期为38周（四分位距37-39周），大多数患者正常阴道分娩（35%，n = 34），而30%的患者进行了紧急剖腹产（n = 29）。出生体重中位数为3120（四分位数间距2690-3410）g。最常见的母体并发症为PPH（56%，n = 54）和感染（22%，n = 21）。最常见的胎儿并发症是早产（23%，n = 22）和低出生体重（17%，n = 16）。我们报告了这种服务模式的有利成果，包括高活产率、低流产率和高出生体重中位数。由于产科/风湿病联合诊所报告的妊娠结局数据有限，这种服务模式可能对其他中心有益。
The purpose of this study was to describe the maternal and fetal outcomes in patients with inflammatory rheumatic diseases attending a joint rheumatology and obstetric clinic in the UK. Electronic records of 98 patients attending the joint rheumatology and obstetric clinic between January 2018 and January 2020 were analysed. Data on patient demographics, characteristics (including age, ethnicity, diagnosis, and medications taken during pregnancy), pregnancy outcomes (miscarriage, stillbirth or live birth), maternal complications [infection, post-partum haemorrhage (PPH) or pre-eclampsia] and fetal complications (sepsis, congenital heart block, prematurity and low birth weight) were tabulated. Subgroups of patients based on maternal diagnosis, medications and Ro/La antibody status were described in a similar manner. The cohort was found to be predominantly Caucasian women >30 years of age, diagnosed with a CTD. Of 98 pregnancies, 97% (n = 95) resulted in a live birth, with only 2% resulting in miscarriage (n = 2) and 1% in stillbirth (n = 1). The median duration of gestation was 38 (interquartile range 37–39) weeks, and the majority of patients had a normal vaginal delivery (35%, n = 34), whereas 30% had emergency Caesarean sections (n = 29). The median birth weight was 3120 (interquartile range 2690–3410) g. The most common maternal complications were PPH (56%, n = 54) and infection (22%, n = 21). The most common fetal complications were prematurity (23%, n = 22) and low birth weight (17%, n = 16). We report favourable outcomes from this service model, including a high live birth rate, a low miscarriage rate and a high median birth weight. With limited reported data of pregnancy outcomes from joint obstetric/rheumatology clinics, this service model might be beneficial in other centres.
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