Pregnancy, Injury, and Birth Outcomes Linking birthfetal death 妊娠与分娩结局，损伤，连接birthfetal死亡.ppt

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2018-06-27 发布于福建
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Pregnancy, Injury, and Birth Outcomes Linking birthfetal death 妊娠与分娩结局，损伤，连接birthfetal死亡.ppt

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Pregnancy, Injury, and Birth Outcomes Linking birthfetal death 妊娠与分娩结局，损伤，连接birthfetal死亡

Pregnancy, Injury, and Birth Outcomes:Linking birth/fetal death certificates to hospital data Melissa Schiff, MD, MPH Victoria Holt, PhD Janet Daling, PhD Injury during Pregnancy A leading cause of morbidity and mortality during pregnancy Occurs in 1 out of 12 pregnancies Injury during pregnancy assessed in studies of maternal mortality Few population-based studies of adverse outcomes after non-fatal injuries during pregnancy Pregnancy Outcomes Following Injury Case series – trauma registries, obstetric services (N=27-476) Purpose – appropriate clinical management, prediction of pregnancy outcomes Outcomes assessed – maternal and fetal death, abruption, preterm labor and delivery Study Aims Describe mechanisms of injury during pregnancy Evaluate the risk of adverse maternal and infant outcomes following injury during pregnancy Methods Retrospective cohort study of pregnant women hospitalized for injury in Washington State 1989-2001 Hospital discharge data linked to birth and fetal death certificates using personal identifiers Subjects Exposed group - injury hospitalization during pregnancy in hospital discharge data, ICD-9CM codes 800 - 959.99 or external causation codes (E codes) ICD codes identified 73.6% E codes identified 90.1% Unexposed comparison group - randomly chosen pregnant women with singleton birth/fetal death, no injury hospitalization Pregnancy Outcomes Ascertained using birth/fetal death certificate and ICD codes Maternal outcomes preterm labor (37 weeks gestation) placental abruption labor induction Cesarean delivery maternal death Pregnancy Outcomes (cont’d) Infant outcomes prematurity (37 weeks gestation) low birth weight (2500 grams) fetal distress fetal death Analysis Demographic, obstetric characteristics comparing uninjured to injured Mechanism of injury Poisson regression - relative risks and 95% confidence intervals Confounders - education, smoking, trimester of initiation of prenatal care Demographic and Obstetric Characteristics Mec