[冰岛2013 - 2018年单胎出生的产后出血,发生率比例和危险因素]
Karen Sol Saevarsdottir1, Emma M Swift2, Kristjana Einarsdottir3
1Faculty of Medicine, University of Iceland.
Laeknabladid
|June 28, 2023
概括
产后出血 (PPH) 在肥胖妇女中增加,特别是在2018年. 紧急剖腹产和仪器分娩是严重PPH (≥1000毫升) 的关键风险因素.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇健康 孕产妇健康
- 公共卫生流行病学 流行病学
背景情况:
- 在全球范围内,产后出血 (PPH) 的发生率正在上升.
- 在ICD-10代码O72可能低估了冰岛的PPH率.
- 一项研究评估了冰岛的PPH发病率和风险因素.
研究的目的:
- 确定冰岛在2013-2018年单胎分娩中产后出血 (PPH) ≥1000毫升的发病率比例.
- 为了确定与≥1000毫升PPH相关的风险因素.
- 为了评估PPH发病率随时间变化的变化,按母亲的身体质量指数 (BMI) 分层.
主要方法:
- 基于人口的队列研究使用冰岛出生登记册 (2013-2018年21110个单独出生).
- 评估PPH发生率使用三个定义:>500毫升,≥1000毫升和ICD-10代码O72.
- 采用二项式回归来分析≥1000毫升PPH的趋势和风险因素,考虑母亲的BMI.
主要成果:
- 在PPH定义之间发现了不一致性 (>500毫升与O72相比).
- 肥胖女性在2018年与2013年相比,PPH≥1000毫升的可能性增加了2倍以上 (OR2.23).
- 对于PPH≥1000毫升最强的危险因素包括紧急剖腹产 (OR 2.68) 和仪器分娩 (OR 2.18);宏观性,初级性和BMI≥30也很重要.
结论:
- 在肥胖女性中,≥1000毫升PPH的发生率有所增加,这可能是由于肥胖对健康的影响和干预措施的增加.
- 诊断代码O72未能注册PPH,因此需要使用以毫升计数的注册血液损失.
- 准确的PPH测量对于理解和管理这种产科并发症至关重要.
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