遗传性出血障碍对母亲出血和其他妊娠结果的影响:基于人口的队列研究
Arafat Ul Alam1, Cynthia Wu2, Padma Kaul1
1Department of Medicine, University of Alberta, Edmonton, Canada.
概括
患有遗传性出血障碍的妇女面临更高的产后出血 (PPH) 和其他不良妊娠结果的风险. 尽管进行了全面的护理,但这种高风险仍然存在,凸显了持续警和管理策略的必要性.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 生殖健康 生殖健康
背景情况:
- 在2003年至2010年期间,加拿大产后出血 (PPH) 发生率呈上升趋势.
- 遗传性出血障碍是PPH的已知的危险因素.
研究的目的:
- 分析过去十年 (2010-2018年) 的PPH趋势.
- 评估出血障碍对怀孕结果的影响.
- 评估受影响妇女在怀孕期间凝血工作的充分性.
主要方法:
- 基于人口的回顾性队列研究使用阿尔伯塔怀孕出生队列 (2010-2018) 进行.
- 鉴定了患有·维勒布兰德病 (VWD) 和血友病的妇女,并与对照组匹配.
- 使用后勤回归分析来确定PPH和其他妊娠并发症的几率.
主要成果:
- 在2010年至2018年期间,整体PPH率保持稳定 (约为每100次交付10.1-10.7).
- 患有出血障碍的女性患PPH (OR 2.3),产前出血 (OR 2.9) 和红细胞输血 (OR 2.8) 的几率明显更高.
- 只有49.5%的患有出血障碍的孕妇在第三个月的凝血因子水平得到检查,即使在因子水平≥0.50 IU/mL时,也会增加PPH风险.
结论:
- 与普通人群相比,患有遗传性出血障碍的女性患有不良妊娠结果 (包括PPH) 的风险更高.
- 目前的综合护理方案不能完全缓解与怀孕期间出血障碍相关的风险增加.
- 对于患有出血障碍的孕妇,需要进一步研究和优化管理策略.
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