对于先天性心脏缺陷的产前护理和产周区域化
Christina Laternser1, William A Grobman2, Cecilia Albaro3
1Division of Pediatric Cardiology, Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
JAMA network open
|November 9, 2025
概括
延迟产前护理的启动增加了先天性心脏缺陷 (CHD) 的新生儿在儿科心脏中心分娩的可能性,特别是严重的病例. 适当的产前检查可能有助于将较温和的冠心病患者引导到适当的非心脏设施.
科学领域:
- 新生儿护理 新生儿护理
- 心脏病学 心脏病学
- 公共卫生 公共卫生
背景情况:
- 区域化旨在将先天性心脏缺陷 (CHD) 的新生儿引导到适当的护理水平.
- 产前护理的充分性对CHDs的分娩地点的影响尚未得到充分理解.
研究的目的:
- 确定产前护理的充分性与在儿童心脏中心为患有心脏病的新生儿分娩的概率之间的关联.
主要方法:
- 采用伊利诺伊州不良妊娠结果报告系统 (2013-2021) 的回顾性数据进行的横截面研究.
- 分析了产前护理启动和与心脏中心分娩的访问频率之间的关联,控制混因素.
- 根据心血管疾病的严重程度分层分析 (轻度,中度,严重).
主要成果:
- 延迟产前护理的启动与心脏中心分娩的可能性更高有关,特别是在严重的心脏病中 (30.2%的增加).
- 对于轻度的心脏病,充足的产前护理与与中等护理相比的心脏中心分娩的可能性较低相关 (-6.7%).
- 产前访问频率与在重症心脏病中心分娩的相关性没有显示.
结论:
- 延迟产前护理的启动与心脏中心新生儿患有心脏病的分娩增加有关,特别是严重的病例.
- 优化产前检查频率可能有助于将较轻的心血管疾病病例转移到非心脏中心.
- 产前护理是区域化冠状动脉疾病护理系统有效运营的关键因素.
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