Obstetric outcomes in women with multiple sclerosis and epilepsy
Obstetric outcomes in women with multiple sclerosis and epilepsy
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DOI：
10.1212/wnl.0b013e3181c3f27d
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发表时间：
2009-12-01
期刊：
影响因子：
9.9
通讯作者：
Chakravarty, Eliza F.
中科院分区：
文献类型：
--
作者：
Kelly, Victoria M.;Nelson, Lorene M.;Chakravarty, Eliza F.
目的：估计全国多发性硬化症（MS）和癫痫妇女的妊娠发生率，并将这些妊娠结局与妊娠前糖尿病（DM）妇女和一般产科人群的妊娠结局进行横断面比较。我们研究了2003-2006年全国住院患者样本，医疗保健成本和利用项目，以估计MS，癫痫，DM和一般产科人群。妊娠结局包括住院时间、高血压疾病（包括先兆子痫（HTN））、胎膜早破（PROM）、宫内生长受限（IUGR）和剖宫产。多变量回归分析使用母亲的年龄和种族/ethnicity作为协variations.Results：估计1880万交付，10,055发生在MS的妇女，4,730与癫痫，和187,239与DM。MS与产前住院（比值比[OR] 1.3，95%置信区间[CI] 1.2-1.5）、IUGR（OR 1.7，95% CI 1.2-2.4）和剖宫产（OR 1.3，95% CI 1.1-1.4）的几率轻度增加相关。同样，癫痫与产前住院率（OR 3.0，95% CI 2.6-3.5）、IUGR（OR 1.9，95% CI 1.2-3.3）和剖宫产率（OR 1.5，95% CI 1.3-1.9）增加相关。两组中HTN和PROM均未增加。DM与所有不良结局的风险增加相关。住院时间在所有组中适度增加与controls.Conclusion：在这个大型的国家数据库研究妊娠结局的妇女与多发性硬化症和癫痫，宫内生长受限和剖宫产率仅略高于一般产科人口没有增加其他不良后果。神经病学（R）2009; 73：1831-1836
Objective: To estimate the national occurrence of pregnancies in women with multiple sclerosis (MS) and epilepsy and to compare these pregnancy outcomes cross-sectionally with those in women with pregestational diabetes mellitus (DM) and the general obstetric population.Methods: We studied the 2003-2006 Nationwide Inpatient Sample, of the Healthcare Cost and Utilization Project, to estimate the number of deliveries in women with MS, epilepsy, DM, and the general obstetric population. Pregnancy outcomes included length of hospital stay, hypertensive disorders including preeclampsia (HTN), premature rupture of membranes (PROM), intrauterine growth restriction (IUGR), and cesarean delivery. Multivariable regression analyses used maternal age and race/ethnicity as covariates.Results: Of an estimated 18.8 million deliveries, 10,055 occurred in women with MS, 4,730 with epilepsy, and 187,239 with DM. MS was associated with mildly increased odds of antenatal hospitalization (odds ratio [OR] 1.3, 95% confidence interval [CI] 1.2-1.5), IUGR (OR 1.7, 95% CI 1.2-2.4), and cesarean delivery (OR 1.3, 95% CI 1.1-1.4). Similarly, epilepsy was associated with increased rates of antenatal hospitalization (OR 3.0, 95% CI 2.6-3.5), IUGR (OR 1.9, 95% CI 1.2-3.3), and cesarean delivery (OR 1.5, 95% CI 1.3-1.9). HTN and PROM were not increased in either group. DM was associated with an increased risk of all adverse outcomes. Length of stay was modestly increased in all groups compared with controls.Conclusion: In this large national database study of pregnancy outcomes in women with multiple sclerosis and epilepsy, rates of intrauterine growth restriction and cesarean delivery were only marginally higher than the general obstetric population without increases in other adverse outcomes. Neurology (R) 2009; 73: 1831-1836