怀孕,喘和恶化:以人口为基础的队列
Bohee Lee1, Ernie Wong1, Tricia Tan2
1National Heart and Lung Institute, Imperial College London, London, United Kingdom.
The European respiratory journal
|August 28, 2025
概括
在怀孕期间喘恶化总体下降,但住院病例增加. 在怀孕期间减少吸入性皮质类固醇 (ICS) 使用是喘恶化的主要可改变的风险因素.
科学领域:
- 生殖医学
- 肺病学
- 公共卫生
背景情况:
- 在怀孕期间喘恶化对母亲和新生儿构成风险.
- 确定可修改的风险因素对于改善妊娠结果至关重要.
- 这项研究重点关注吸入性皮质类固醇 (ICS) 作为关键可修改因素.
研究的目的:
- 在怀孕期间分析喘恶化模式.
- 确定恶化的风险因素,强调可修改的风险因素,如ICS使用.
- 了解ICS降低对孕妇喘控制的影响.
主要方法:
- 一项基于英国的队列研究 (2004-2020年) 分析了初级保健和医院数据.
- 确定了患有喘的孕妇,并根据特定的临床事件定义了恶化.
- 多变量逻辑回归评估了母体因素,恶化和ICS使用之间的关联.
主要成果:
- 在怀孕期间,喘恶化总数下降了约30%,但在第二和第三季度,与住院相关的恶化增加了30-45%.
- 31%的妇女在怀孕期间减少了他们的ICS处方.
- 减少ICS使用,病史恶化,以及怀孕前大量的ICS+预防剂处方是恶化的重要风险因素.
结论:
- 尽管整体下降,但在怀孕期间与住院相关的喘恶化增加.
- 在怀孕期间减少吸入性皮质类固醇 (ICS) 的使用是严重的,可改变的恶化风险因素.
- 其他关键风险因素是2型炎症和妊娠前不理想的喘控制.
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