祖母多胎化是否是输血的独立风险因素?
Emmanuel Attali1,2,3, Daniel Gabbai4,5, Lee Reicher4,5
1Lis Maternity Hospital, Sourasky Medical Center, Tel Aviv, Israel. attaliemmanuel@gmail.com.
Reproductive sciences (Thousand Oaks, Calif.)
|November 27, 2023
概括
令人惊的是,被定义为五次或更多次先前分娩的大多对,被发现可以保护产后红细胞输血. 这项研究挑战了以前关于与高妊娠结果平价相关的风险的假设.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖健康 生殖健康
背景情况:
- 大多夫妇 (≥5次先前分娩) 与不良妊娠结果,特别是产后出血和输血之间的关联仍在争论中.
- 最近的文献提出了相互矛盾的证据,关于祖母多亲子对母亲和新生儿发病率的风险.
研究的目的:
- 为了研究大多夫妻制与产后红细胞 (RBC) 输血的需要之间的联系.
主要方法:
- 一个回顾性队列研究于2011-2019年在大学附属的高等医疗中心进行.
- 女性被分为无双生 (0次分娩),多次生 (1-4次分娩) 或大多次生 (≥5次分娩).
- 主要结局是指数入院期间的红细胞输血,并对混因子进行调整.
主要成果:
- 在87,343次分娩中,1.7%的妇女是大多胞胎,1.8%接受了红细胞输血.
- 与红细胞输血相关的因素包括剖腹产,巨,早产,多胎妊娠,产前贫血,血小板减少,IUFD和延长的分娩.
- 在对混因素进行控制后,大多平价被确定为红细胞输血的独立保护因子 (RR=0.2;95% CI 0.007-0.56).
结论:
- 仅仅是大多偶数与控制混杂因素时产后输血风险的增加无关.
- 这项研究表明,大多对抗产后红细胞输血的保护作用,与一些先前的信念相反.
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