怀孕和大动脉解剖或破裂的风险:一个队列交叉分析
Hooman Kamel1, Mary J Roman2, Alex Pitcher2
1From Department of Neurology (H.K.), Feil Family Brain and Mind Research Institute (H.K.), and Division of Cardiology M.J.R., R.B.D.), Weill Cornell Medicine, New York, NY; and Radcliffe Department of Medicine, Division of Cardiovascular Medicine, University of Oxford, Oxford, UK (A.P.). hok9010@med.cornell.edu.
Circulation
|August 6, 2016
概括
怀孕显著增加了主动脉解剖或破裂的风险. 这项研究发现,与一年后相比,怀孕和分娩后的风险增加了四倍,这凸显了心血管事件的关键时期.
科学领域:
- 心血管健康
- 产科和妇科
- 公共卫生研究
背景情况:
- 怀孕期间的大动脉解剖和破裂已被记录在案例系列中.
- 有限的基于人群的数据证实了怀孕与大动脉并发症之间的关联.
研究的目的:
- 调查怀孕与大动脉解剖或破裂的风险之间的关联.
- 量化这些主动脉事件在怀孕期间和产后的风险.
主要方法:
- 采用了来自美国三个州的大规模医疗数据的队列交叉研究设计.
- 包括12岁及以上的孕妇 (2005年至2013年).
- 在分娩前6个月至分娩后3个月的风险期,与一年后的对照期评估了主动脉解剖或破裂的复合结果.
主要成果:
- 分析了超过650万例怀孕,在风险期发现了36例主动脉解剖/断裂,在对照期发现了9例.
- 在怀孕/产后期间,大动脉并发症的发生率为每百万患者中5. 5%,而对照期为每百万患者中1. 4.
- 怀孕与显著增加的风险相关 (IRR为4.0;95% CI为2. 0-8. 2).
结论:
- 在怀孕和产后期间,大动脉解剖或破裂的风险大大增加.
- 这种增加的风险强调了怀孕和分娩后心血管监测的重要性.
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