JAMA Network Open:超430万人群数据,首次怀孕先兆子痫患者癌症发生率评估

2021-06-26 MedSci原创 MedSci原创

先兆子痫是指妊娠24周左右,在高血压、蛋白尿基础上,出现头痛、眼花、恶心、呕吐、上腹不适等症状,是一系列晚期妊娠并发症(称为胎盘介导的并发症或胎盘综合征)中最常见的综合征。

先兆子痫是指妊娠24周左右,在高血压、蛋白尿基础上,出现头痛、眼花、恶心、呕吐、上腹不适等症状,是一系列晚期妊娠并发症(称为胎盘介导的并发症或胎盘综合征)中最常见的综合征。

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先前有研究显示, 先兆子痫在引起重大生理变化的同时,可能与晚年发生癌症有关。然而,关于先兆子痫与癌症之间关联的数据不一致,近日,发表在JAMA Network Open杂志的一项研究,评估首次怀孕期间先兆子痫与不同癌症发生风险之间的关系。

这项回顾性队列研究使用了法国医院出院数据库的数据,以确定201011日至20191231日期间与怀孕相关的住院的所有女性个体。同时,利用法国私立和公立医院住院医疗行政登记的数据来评估参与者的暴露、合并症和癌症的发生。使用Cox模型来分析首次怀孕期间发生先兆子痫与癌症发生风险之间的关系,包括骨髓增生异常或骨髓增生性疾病。

结果显示,共纳入4322970名女性,首次发现怀孕时的平均年龄为29.6岁,其中1.1%的女性诊断出先兆子痫。在长达8年的随访中,有有29173人(0.7%)被诊断为癌症,但并没有发现患有先兆子痫的女性与未患先兆子痫的女性,总体患癌风险之间的差异。

每千人年的癌症发病率

然而,先兆子痫与骨髓增生异常综合征或骨髓增生性疾病和肾癌的发生风险增加有关,而乳腺癌和宫颈癌的发生风险减少有关。当分析胎盘疾病的谱系时,这些结果仍然存在。

对骨髓增生异常或骨髓增生性疾病和癌症的敏感性分析

综上, 2012 年至 2019 年法国出院数据库中的孕妇中,首次怀孕期间患有先兆子痫的孕妇骨髓增生异常或骨髓增生性疾病和肾癌的发病率增加,而乳腺癌和宫颈癌的发病率略有下降。这些关联可能反映了子痫前期/子痫和这些病症之间潜在的共同因素,未来有待探索的共同病理生理因素。

原始出处

Chris Serrand, MD1,2Thibault Mura, MD, PhD1,2Pascale Fabbro-Peray, MD, PhD1,2,3et al.Assessment of All-Cause Cancer Incidence Among Individuals With Preeclampsia or Eclampsia During First Pregnancy.JAMA Netw Open. 2021;4(6):e2114486. doi:10.1001/jamanetworkopen.2021.14486

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    2021-09-12 feather89
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    2022-02-10 canlab
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    2021-06-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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