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首页> 外文期刊>American Journal of Obstetrics and Gynecology >Acute pyelonephritis in pregnancy: An 18-year retrospective analysis
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Acute pyelonephritis in pregnancy: An 18-year retrospective analysis

机译：妊娠急性肾盂肾炎：18年回顾性分析

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Objective We sought to describe the incidence of acute pyelonephritis in pregnancy, and to assess its association with perinatal outcomes in an integrated health care system. Study Design A retrospective cohort study was performed using medical records on 546,092 singleton pregnancies delivered in all Kaiser Permanente Southern California hospitals from 1993 through 2010. These medical records include the perinatal service system along with inpatient and outpatient encounter files. Adjusted odd ratios (ORs) and 95% confidence intervals (CIs) were used to estimate associations. Results The incidence of acute antepartum pyelonephritis was 0.5% (2894/543,430). Women with pyelonephritis in pregnancy were more likely to be black or Hispanic, young, less educated, nulliparous, initiate prenatal care late, and smoke during pregnancy. Pregnancies of women with pyelonephritis compared to those without were more likely to be complicated by anemia (26.3% vs 11.4%; OR, 2.6; 95% CI, 2.4-2.9), septicemia (1.9% vs 0.03%; OR, 56.5; 95% CI, 41.3-77.4), acute pulmonary insufficiency (0.5% vs 0.04%; OR, 12.5; 95% CI, 7.2-21.6), acute renal dysfunction (0.4% vs 0.03%; OR, 16.5; 95% CI, 8.8-30.7), and spontaneous preterm birth (10.3% vs 7.9%; OR, 1.3; 95% CI, 1.2-1.5). Most of the preterm births occurred between 33-36 weeks (9.1%). Conclusion We characterize the incidence of pyelonephritis in an integrated health care system where routine prenatal screening for asymptomatic bacteriuria is employed. Maternal complications are commonly encountered and the risk of preterm birth is higher than the baseline obstetric population.
机译：目的我们试图描述妊娠合并急性肾盂肾炎的发生率，并评估其与综合医疗体系中围产期结局的关系。研究设计回顾性队列研究使用了1993年至2010年间在南加州所有凯撒永久医院所有分娩的546,092例单胎妊娠的病历。这些病历包括围产期服务系统以及住院和门诊遭遇档案。调整后的奇数比（OR）和95％置信区间（CI）用于估计关联。结果急性产前肾盂肾炎的发生率为0.5％（2894 / 543,430）。怀孕期间患有肾盂肾炎的妇女更可能是黑人或西班牙裔，年轻，文化程度较低，未生育，晚期开始产前检查以及怀孕期间吸烟。与没有肾盂肾炎的妇女相比，患有肾盂肾炎的妇女更容易并发贫血（26.3％vs 11.4％; OR，2.6; 95％CI，2.4-2.9），败血病（1.9％vs 0.03％; OR，56.5; 95） ％CI，41.3-77.4），急性肺功能不全（0.5％vs 0.04％; OR，12.5; 95％CI，7.2-21.6），急性肾功能不全（0.4％vs 0.03％; OR，16.5; 95％CI，8.8 -30.7）和自然早产（10.3％比7.9％; OR为1.3; 95％CI为1.2-1.5）。大多数早产发生在33-36周之间（9.1％）。结论我们利用常规的产前筛查无症状菌尿的综合保健系统来表征肾盂肾炎的发病率。产妇并发症经常发生，早产的风险高于产科基线人群。

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