在那些患有自身免疫结缔组织疾病的人中,母亲和胎儿的结局
Nada Alrifai1, Anushree Puttur2, Fares Ghanem3
1Department of Rheumatology, Cooper University, Camden, NJ, USA.
Clinical rheumatology
|November 30, 2024
概括
患有自身免疫结缔组织疾病 (CTD) 的孕妇面临显著更高的母亲和胎儿不良后果的风险,包括死亡和死产. 管理策略必须根据个体CTD亚型量身定制,以获得更好的妊娠结果.
科学领域:
- 产科和妇科 产科和妇科
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
背景情况:
- 自身免疫性结缔组织疾病 (CTD),如全身性红斑狼 (SLE),全身性硬化症 (SSc) 和类风湿性关节炎 (RA),主要影响生育年龄的女性.
- 这些情况与怀孕期间母亲和胎儿并发症的风险增加有关.
研究的目的:
- 为了比较具有和没有自身免疫性CTD的孕妇患者的孕妇和胎儿结局.
- 在怀孕期间识别与不同CTD亚型相关的特定风险.
主要方法:
- 一项以人口为基础的回顾性队列研究,利用国家住院患者数据.
- 分析2015年10月至2020年12月间的分娩情况,比较CTD患者和没有CTD患者之间的结果.
- 调整回归分析以考虑患者的特征.
主要成果:
- 该研究包括超过1880万次分娩,其中50450例被诊断为自身免疫性CTD.
- 患有CTD的患者的孕产妇死亡,高血压疾病,急性损伤,周围心肌病,败血症和ARDS的几率明显更高.
- 不良的胎儿结果更为常见,包括更高的几率小的妊娠年龄胎儿,死产和早产,在CTD亚型 (SLE,RA,SSc) 之间存在差异.
结论:
- 与没有CTD的孕妇相比,患有自身免疫CTD的孕妇经历的孕妇和胎儿结果明显更差.
- 在不同CTD亚型中,并发症的发生频率和类型各不相同.
- 预孕咨询和个性化管理计划对于改善这一群体的怀孕结果至关重要.
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