妇女的不良妊娠结果和长期死亡率
Casey Crump1,2, Jan Sundquist3, Kristina Sundquist3
1Department of Family and Community Medicine, McGovern Medical School, The University of Texas Health Science Center, Houston.
JAMA internal medicine
|April 15, 2024
概括
患有不良妊娠结果的妇女,如早产或孕前,面临更高的长期死亡风险. 这些风险持续超过40年,强调了早期干预和持续健康监测的必要性.
科学领域:
- 生殖健康 生殖健康
- 心血管健康 心血管健康
- 流行病学 流行病学
背景情况:
- 不良妊娠结果 (APO) 与未来的心脏代谢风险有关.
- 在APO后的长期死亡风险尚未得到充分了解.
- 早期识别和预防策略需要了解长期死亡率.
研究的目的:
- 调查五个主要APO与长期死亡率之间的关联.
- 量化一个大规模的,基于人口的女性队列中的死亡风险.
主要方法:
- 使用瑞典医疗出生登记册进行国家队列研究 (1973-2015).
- 包括2,195,667名单独分娩的妇女.
- 分析了截至2018年12月31日的所有原因和特定原因死亡率,使用考克斯回归和共生分析.
主要成果:
- 所有五种APO (妊娠糖尿病,早产,对于妊娠年龄来说小,高血压疾病,孕前) 都独立地与死亡率增加有关.
- 所有原因死亡的危险比率从1.13为孕前到1.52为妊娠期糖尿病.
- 死亡风险的增加持续了分娩后30-46年,并且仅部分由家族因素解释.
结论:
- APO显著增加了长期死亡风险,其影响持续了40多年.
- 患有APO的女性需要积极的长期健康监测来管理慢性疾病.
- 预防策略和早期干预对于减轻这一群体的过早死亡率至关重要.
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