AJKD:ESKD妇女的产科分娩结局

2019-11-30 xing.T MedSci原创

由此可见,2002年至2015年,接受移植或HD治疗的育龄期ESKD妇女的分娩率有所增加。移植功能正常的妇女早产的可能性较小,但剖宫产的可能性较大。在2012年至2015年期间,ESKD孕妇的门诊强化HD治疗并不频繁。

终末期肾脏病(ESKD)妇女的生育力下降,并且妊娠并发症的风险增加。近日,肾脏病学权威杂志Am J Kidney Dis上发表了一篇研究文章,这项研究旨在调查美国ESKD妇女队列的长期趋势和产科分娩结局。

这项回顾性队列参与者为2002年至2015年期间在美国肾脏数据系统中注册的18至44岁的ESKD妇女。ESKD患者的类型包括血液透析[HD]、腹膜透析和移植。结局为婴儿分娩、早产、剖宫产。未调整分娩率为研究期间每年18至44岁年龄段妇女中每1000患者的分娩人数,并按ESKD类型进行分层。研究人员使用Logistic回归模型评估分娩、早产和剖宫产与患者特征之间的相关性。

接受HD手术的妇女和接受肾移植的妇女的分娩率分别从每1000名患者每年2.1%升至3.6%和3.1%升至4.6%(所有P<0.001)。接受腹膜透析的患者的分娩率较低,没有明显增加(P=0.9)。与接受HD手术的妇女相比,接受移植手术的妇女早产的可能性较小(OR为0.92;95%CI为0.84-1.00),尽管剖宫产的可能性更高(OR为1.18;95%CI为1.06-1.31)。对于2012年至2015年期间发生的分娩,在分娩前30天内,接受HD治疗的女性中有75%的患者每周接受4次或更少的门诊HD治疗,而25%的患者每周接受5次以上的HD治疗。

由此可见,2002年至2015年,接受移植或HD治疗的育龄期ESKD妇女的分娩率有所增加。移植功能正常的妇女早产的可能性较小,但剖宫产的可能性较大。在2012年至2015年期间,ESKD孕妇的门诊强化HD治疗并不频繁。 

原始出处:

Andrea L. Oliverio,et al.Obstetric Deliveries in US Women With ESKD: 2002-2015.Am J Kidney Dis 2019.https://www.ajkd.org/article/S0272-6386(19)31058-3/fulltext

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    2020-02-10 zhyy88
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    2019-12-02 linlin2312
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