围产期死亡率的风险与妊娠期哮喘的关系
2009/03/06
背景：有13项研究调查显示，妊娠期哮喘没有增加围产期死亡率的风险。应该小心解释这些研究中的大多数结果，因为他们的统计学分析是局限的。
目的：评价妊娠期母亲哮喘是否会增加围产期死亡率。
方法：在加拿大的三个行政管理区的数据库中选择数据，我们按队列列出哮喘组和非哮喘组的妇女，她们在1990～2002年至少有过1次妊娠。围产期死亡率通过诊断标准来确定。我们按照广泛估计方程式（GEE models)评估哮喘组和非哮喘组妇女的围产期死亡率的校正优势比（adjusted odds ratio）。第一个模式包括所有的潜在因素(except SGA)，第二个模式包括出生体重、出生时和小胎龄时妊娠的年龄，第三个模式包括出生体重、小胎龄时妊娠的年龄。分层分析出生体重和出生时妊娠的年龄。
结果：队列分析了单胎哮喘妇女13 100例和单胎非哮喘妇女28 042例，围产期死亡率的自然OR值为1.35, 95% CI (1.08-1.67)。当校正了出生体重和出生时妊娠的年龄后OR值降低至0.93 (95% CI: 0.75-1.17)。哮喘妇女的低体重出生儿和早产儿的发生率明显高于非哮喘的妇女。
结论：哮喘妇女明显增加了其出生低体重儿和早产儿的发生率，这能够部分解释母亲哮喘和围产期死亡率风险增加之间的关联性。
（苏楠 卫生部中日友好医院呼吸内科 100029 摘译 ）
（Thorax.2008 Nov 13）
Thorax. 2008 Nov 13.
Risk of perinatal mortality associated with asthma during pregnancy.
Breton MC, Beauchesne MF, Lemière C, Rey E, Forget A, Blais L.
Universite de Montreal, Canada.
BACKGROUND: Thirteen studies investigating the association between asthma during pregnancy and perinatal mortality reported generally no increased risk. Most of these studies should be interpreted with caution because they were limited in terms of statistical power.
OBJECTIVE: To evaluate whether maternal asthma during pregnancy increases the risk of perinatal mortality.
METHODS: Through three administrative databases from Québec (Canada), we formed a cohort including asthmatic and non-asthmatic women who had at least one pregnancy between 1990 and 2002. Perinatal mortality was identified through diagnostic codes. We estimated the adjusted odds ratio of perinatal mortality comparing asthmatic and non-asthmatic women with Generalized Estimation Equations (GEE) models. The first model included all potential confounders (except SGA) while the second model excluded birth weight, gestational age at birth and SGA and the third model excluded birth weight, gestational age at birth but included only SGA. This analysis was also stratified for birth weight and gestational age at birth.
RESULTS: The cohort was formed of 13 100 and 28 042 single pregnancies from asthmatic and non-asthmatic women. The crude OR of perinatal mortality was 1.35, 95% CI (1.08-1.67). The OR decreased to 0.93 (95% CI: 0.75-1.17) after adjustment for birth weight and gestational age at birth. Asthmatic women had a higher rate of low birth weight baby and preterm delivery compared to non-asthmatic.
CONCLUSION: The increased risk of low birth weight baby and premature delivery among asthmatic women may partly explain the association between maternal asthma and the increased risk of perinatal mortality.
上一篇：
宫内胚胎时期接触农作物有利于预防哮喘、干草热和湿疹
下一篇：
哮喘患者的肥胖及其运动习惯
