Research question

What is the association between congenital adrenal hyperplasia (CAH) and pregnancy, delivery and neonatal outcomes, using a population database cohort.

Design

Retrospective study using the Health Care Cost and Utilization Project-Nationwide Inpatient Sample database from 2004–2014. ICD-9 code 255.2 was used to extract the cases of CAH. Pregnancies complicated with CAH were compared with the other pregnancies. All confounding variables were adjusted using multivariate logistic regression, based on any significant differences between the two groups.

Results

A total of 9,096,788 deliveries occurred during the study period. Two hundred and ninety-nine pregnant women had CAH. Chorioamnionitis was higher in CAH compared with controls after controlling for risk factors (adjusted OR 2.67, 95% CI 1.17 to 6.06). The rates of caesarean section and maternal infection were also higher in CAH than controls (adjusted OR 2.10, 95% CI 1.44 to 3.07 and adjusted OR 2.63, 95% CI 1.22 to 5.63, respectively). Risk of gestational diabetes and pregnancy-induced hypertension rates were not significantly different in CAH (adjusted OR 1.53, 95% CI 0.91 to 2.58 and adjusted OR 0.87, 95% CI 0.49 to 1.56, respectively). At birth, 8% and 2.2% of the neonates were found to be small for gestational age in the CAH and the control groups, respectively (adjusted OR 3.37, 95% CI 1.86 to 6.11). Congenital anomalies were encountered in 2.7% and 0.4% in the CAH and control groups, respectively (adjusted OR 5.24, 95% CI 2.31 to 11.90).

Conclusions

Women with CAH were at risk of complications and fetal anomalies. Expected increases in rates of hypertension and gestational diabetes were not encountered. These patients will benefit from surveillance to decrease morbidity.

中文翻译：

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先天性肾上腺皮质增生症妇女的妊娠、分娩和新生儿结局：对美国大型数据库的研究

研究问题

先天性肾上腺皮质增生症 (CAH) 与妊娠、分娩和新生儿结局之间的关联是什么，使用人口数据库队列。

设计

使用 2004-2014 年医疗保健成本和利用项目-全国住院样本数据库的回顾性研究。使用ICD-9代码255.2提取CAH病例。将并发 CAH 的妊娠与其他妊娠进行比较。根据两组之间的任何显着差异，使用多变量逻辑回归调整所有混杂变量。

结果

研究期间总共发生了 9,096,788 次分娩。299 名孕妇患有 CAH。在控制了风险因素后，CAH 中绒毛膜羊膜炎的发生率高于对照组（调整后的 OR 2.67，95% CI 1.17 至 6.06）。CAH 的剖腹产率和母体感染率也高于对照组（分别为调整后的 OR 2.10、95% CI 1.44 至 3.07 和调整后的 OR 2.63、95% CI 1.22 至 5.63）。CAH 的妊娠糖尿病风险和妊娠高血压发生率无显着差异（分别为调整后的 OR 1.53、95% CI 0.91 至 2.58 和调整后的 OR 0.87、95% CI 0.49 至 1.56）。在出生时，分别有 8% 和 2.2% 的新生儿被发现在 CAH 和对照组中小于胎龄（调整 OR 3.37，95% CI 1.86 至 6.11）。

结论

患有 CAH 的女性有出现并发症和胎儿畸形的风险。没有遇到高血压和妊娠糖尿病发生率的预期增加。这些患者将受益于监测以降低发病率。