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英研究显示孕妇分娩前后需防患肺结核风险

2011/12/15 来源:科学网
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英国卫生防护局等机构的研究人员在新一期《美国呼吸道与危重护理学杂志》上报告说,他们调查了英国在1996年至2008年间约20万名女性分娩前后的医疗记录,结果显示她们在生小孩后6个月内患肺结核的几率要比非孕产期间高出约70%。

孕妇分娩前后需防患肺结核风险

英国的一项新研究显示,孕妇分娩后6个月内患肺结核的风险会明显上升,因此需要注意相关迹象并加强卫生保健。

英国卫生防护局等机构的研究人员在新一期《美国呼吸道与危重护理学杂志》上报告说,他们调查了英国在1996年至2008年间约20万名女性分娩前后的医疗记录,结果显示她们在生小孩后6个月内患肺结核的几率要比非孕产期间高出约70%。

领导该研究的多米尼克•曾纳说,虽然数据显示分娩后一段时期内患肺结核的风险较高,但可以推论部分女性孕期感染结核杆菌的风险较高,上述患病女性可能是在怀孕期间被感染,分娩后才明显出现肺结核症状。其他一些医学研究也显示,女性怀孕期间对许多疾病的抵抗力会下降。

研究人员因此呼吁人们加强对孕妇和产妇的看护,如果出现肺结核迹象应及时就医。这些迹象包括发烧、夜汗多、不断咳嗽、体重减轻和唾液带血等。研究人员说,肺结核已是可以治愈的疾病,但如果放任病情发展仍可能危及生命。

 

Risk of Tuberculosis in Pregnancy: A National, Primary Care Based Cohort and Self-Controlled Case Series Study

Dominik Zenner, Michelle E Kruijshaar, Nick Andrews, and Ibrahim Abubakar

Objective Tuberculosis (TB) disease adversely affects mother and child, and strategies to control TB in this group are important. The aim of this study was to analyse the epidemiology of TB in pregnancy, and establish whether pregnancy is an independent risk factor for TB. Methods The UK-wide cohort study was based on the General Practitioner Research Database (GPRD), enrolling all women with pregnancies between 1996 and 2008. Incidence rates (IR) and ratios (IRR) of TB events during pregnancy, 6 months post-partum, and outside pregnancy were calculated and compared using Poisson regression. A nested self-controlled case series (SCCS) compared the risk of TB in these periods, adjusting for individual and time-bound confounders. Results The crude TB rate for the combined pregnancy and post-partum period was 15.4 per 100,000 person years (py), significantly higher than outside of pregnancy (9.1 per 100,000 py, p=0.02). Adjusting for age, region and socio-economic status the post-partum TB risk was significantly higher than outside pregnancy (IRR 1.95, CI 1.24-3.07), whereas there was no significant increase during pregnancy (IRR 1.29, CI 0.82-2.03). These observations were confirmed in the SCCS (IRR 1.62, CI 1.01-2.58 and 1.03, CI 0.64-1.65 respectively). Conclusions The incidence of TB diagnosis is significantly increased post-partum. Although we did not find an increase during pregnancy, the post-partum incidence may reflect an increase during pregnancy given diagnostic, immunological and administrative delays. Clinicians' awareness should be improved and the effectiveness of public health policy measures such as targeted screening of pregnant and post-partum women in high-risk groups should be evaluated.

文献链接:http://ajrccm.atsjournals.org/cgi/content/abstract/201106-1083OCv1
 

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