First-trimester pyelonephritis is associated with later initiation of prenatal care: a retrospective cohort analysis.
First-trimester pyelonephritis is associated with later initiation of prenatal care: a retrospective cohort analysis.
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妊娠早期肾盂肾炎与较晚开始产前护理相关：一项回顾性队列分析。
DOI：
10.1055/s-0031-1295655
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发表时间：
2012
影响因子：
2
通讯作者：
Anderson,BrennaL
中科院分区：
文献类型：
--
作者：
McDonnold,MollieA;Friedman,AlexanderM;Raker,ChristinaA;Anderson,BrennaL
我们试图确定尚未接受产前护理的肾盂肾炎妊娠患者与接受产前护理的患者的发病率、频率和人口统计学特征。我们对2004年1月至2007年6月在一家三级医院连续入院的254例肾盂肾炎患者进行了回顾性队列分析，比较了接受产前护理的患者和没有接受产前护理的患者。样本大小足以检测两组入院时间的1天差异，α分别为0.05%和80%。分类变量比较采用Fisher精确检验，连续变量比较采用Wilcoxon秩和或Kruskal-Wallis检验。在这254例中，35例(13.8%)发生在未建立产前保健的妇女身上。住院时间的主要结果没有差别。总体而言，29例(11.4%)发生在12周之前，其中，明显更多的患者尚未建立产前护理(18例比11例，p<； 0.0001)。大多数发生在12周前的肾盂肾炎病例发生在没有产前护理的妇女中。尽管美国预防服务工作组指南建议在12至16周进行尿液培养筛查，但这些发现支持在较早孕周开始筛查。
We sought to determine the morbidity, frequency, and demographics of pregnant patients with pyelonephritis not yet receiving prenatal care compared with patients with prenatal care. We performed a retrospective cohort analysis of 254 consecutive admissions for pyelonephritis from January 2004 to June 2007 at a single tertiary hospital comparing patients with prenatal care versus patients with no prenatal care. The sample size was adequate to detect a 1-day difference in length of admission between the two groups with an α of 0.05 and 80% power. Categorical variables were compared by Fisher exact test, and continuous variables were compared by the Wilcoxon rank sum or Kruskal-Wallis test. Of the 254 cases, 35 (13.8%) occurred in women who had not established prenatal care. There was no difference in the primary outcome of hospital length of stay. Overall, 29 cases (11.4%) occurred prior to 12 weeks and of these, significantly more patients presented having not established prenatal care (18 versus 11,p< 0.0001). The majority of cases of pyelonephritis that occur prior to 12 weeks are among women with no prenatal care. Although the U.S. Preventative Services Task Force guidelines advise screening urine culture at 12 to 16 weeks, these findings support initiating screening at an earlier gestational age.