多重母性慢性病症和严重新生儿发病率和死亡率的风险
Hilary K Brown1,2,3,4, Kinwah Fung4, Eyal Cohen4,5,6,7,8
1Department of Health and Society, University of Toronto Scarborough, Toronto, Ontario, Canada.
JAMA network open
|January 23, 2026
概括
患有多种慢性疾病 (MCC) 的母亲的新生儿面临更高的严重发病和死亡风险. 早期咨询和加强产前监测对于管理母亲健康和改善新生儿结果至关重要.
科学领域:
- 围产期健康 围产期健康
- 孕产妇和胎儿的医学
- 公共卫生 公共卫生
背景情况:
- 近16%的孕妇患有多重慢性疾病 (MCC).
- MCC增加了严重孕产妇发病率和死亡率的风险.
- 在这个人群中,新生儿的结果还不太清楚.
研究的目的:
- 检查母亲慢性疾病的数量和复杂性与重症新生儿发病率或死亡率 (SNM-M) 风险之间的关联.
- 调查MCC复杂性,心脏代谢MCC和MCC严重程度对SNM-M的影响.
主要方法:
- 在加拿大安大略省 (2012-2021) 进行基于人口的队列研究.
- 包括超过100万活产的婴儿.
- 修改Poisson回归分析了母体MCC和SNM-M之间的关联,并对共变量进行了调整.
主要成果:
- 随着母亲慢性疾病的数量增加,SNM-M的风险以剂量-反应的方式增加.
- 与没有慢性疾病的母亲的新生儿相比,SNM-M的调整后相对风险为1.26 (1个条件),1.58 (2个条件) 和2.01 (≥3个条件).
- 复杂,心脏代谢和严重的MCC与SNM-M显著增加的风险有关.
结论:
- 越来越多的先前存在的母体慢性疾病与严重的新生儿发病率或死亡率的风险增加有关.
- 对于患有MCC的妇女,建议提供预孕咨询,优化慢性疾病管理和加强产前监测.
- 这些干预措施可以帮助更早地发现并发症,并为新生儿提供更好的支持.
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