背景:孕妇炎症性肠病(IBD)与心血管结局之间的关系尚未得到彻底研究。我们的目的是评估住院分娩期间心血管疾病和心律失常的几率,并确定与IBD孕妇心血管并发症相关的因素。
方法:我们对来自全国住院患者样本的数据进行了回顾性分析,从患有和不患有IBD的孕妇的分娩入院中获得,通过国际疾病分类代码确定,从2009年到2019年。使用回归模型,我们比较了两组发生心血管并发症的几率,调整传统的心血管危险因素作为混杂变量。
结果:我们的研究包括71,361例IBD妊娠和41,117,443例没有这种情况的妊娠。十年来,妊娠期IBD的发病率增加了近三倍。与没有IBD的怀孕相比,涉及IBD孕妇的患者出现心血管并发症的可能性增加,调整后比值比(AOR)为1.37(95%CI,1.29-1.46)。这种增加的风险包括一系列条件,包括围产期心肌病(AOR,9.45;95%CI,3.86-23.15),心律失常(AOR,2.03;95%CI,1.59-2.60),和妊娠期高血压疾病(AOR,1.51;95%CI,1.37-1.66),尤其是先兆子痫,子痫,和溶血综合征,肝酶升高,和低血小板计数(HELLP综合征)。妊娠合并IBD也与静脉血栓栓塞的几率高三倍(AOR,3.91;95%CI,1.45-10.48)。
结论:妊娠IBD患者在接生期间发生心血管并发症的几率增加,独立于传统的心血管危险因素。需要进一步的研究来阐明潜在的机制,并为这一高危人群制定有针对性的预防策略。
BACKGROUND: The relationship between inflammatory bowel disease (IBD) and cardiovascular outcomes among pregnant women has yet to be thoroughly investigated. Our aim is to assess the odds of cardiovascular disease and cardiac arrhythmias during hospital admissions for delivery and identify contributing factors associated with cardiovascular complications in pregnant women with IBD.
METHODS: We performed a retrospective analysis of data from the National Inpatient Sample, obtained from delivery admissions of pregnant women with and without IBD, identified via International Classification of Diseases codes, from 2009 to 2019. Using a regression model, we compared the odds of cardiovascular complications between these two groups, adjusting for traditional cardiovascular risk factors as confounding variables.
RESULTS: Our study included 71,361 pregnancies with IBD and 41,117,443 pregnancies without this condition. The incidence of IBD in pregnancy rose near three-fold increase over the decade. In comparison to pregnancies without IBD, those involving pregnant patients with IBD exhibited an increased likelihood of encountering cardiovascular complications, with an adjusted odds ratio (AOR) of 1.37 (95% CI, 1.29-1.46). This heightened risk encompasses a range of conditions, including peripartum cardiomyopathy (AOR, 9.45; 95% CI, 3.86-23.15), cardiac arrhythmias (AOR, 2.03; 95% CI, 1.59-2.60), and hypertensive disorders of pregnancy (AOR, 1.51; 95% CI, 1.37-1.66), notably preeclampsia, eclampsia, and the syndrome of hemolysis, elevated liver enzymes, and low platelet count (HELLP syndrome). Pregnancies with IBD were also associated with three-fold higher odds of venous thromboembolism (AOR, 3.91; 95% CI, 1.45-10.48).
CONCLUSIONS: Pregnant patients with IBD had an increased odds of cardiovascular complications during delivery admissions, independent of traditional cardiovascular risk factors. Further research is needed to elucidate the underlying mechanisms and develop targeted prevention strategies for this high-risk population.