Mode of delivery in hemophilia: vaginal delivery and Cesarean section carry similar risks for intracranial hemorrhages and other major bleeds

被引：32

作者：

Andersson, Nadine G. ^{[1
,2
]}

Chalmers, Elizabeth A. ^{[3
]}

Kenet, Gili ^{[4
,5
]}

Ljung, Rolf ^{[2
]}

Makipernaa, Anne ^{[6
]}

Chambost, Herve ^{[7
,8
]}

Altisent Roca, C. ^{[9
]}

Alvarez Roman, M. T. ^{[10
]}

Buehrlen, M. ^{[11
]}

van den Berg, H. M. ^{[12
]}

Chalmers, E. ^{[3
]}

Chambost, H. ^{[8
,13
]}

Rosa Cid, A. ^{[14
]}

Claeyssens, S. ^{[15
]}

Escuriola, C. ^{[16
]}

Fischer, K. ^{[17
]}

Van Geet, C. ^{[18
]}

Kobelt, R. ^{[19
]}

Koenigs, C. ^{[20
]}

Kurnik, K. ^{[21
]}

Liesner, R. ^{[22
]}

Ljung, R. ^{[2
,23
,24
]}

Makipernaa, A. ^{[25
,26
]}

Molinari, A. ^{[27
]}

Muntean, W. ^{[28
]}

Nolan, B. ^{[29
]}

Oldenburg, J. ^{[30
]}

Perez Garrido, R. ^{[31
]}

Platokouki, H. ^{[32
]}

Rafowicz, A. ^{[33
]}

Ranta, S. ^{[34
]}

Santagostino, E. ^{[35
]}

Mancuso, M. E. ^{[35
]}

Bonomi, Angelo Bianchi ^{[35
]}

Mikkelsen, T. Stamm ^{[36
]}

Thomas, A. ^{[37
]}

Kenet, G. ^{[39
]}

Williams, M. ^{[38
]}

Carcao, M. ^{[40
]}

Rivard, G. ^{[41
]}

机构：

[1] Skane Univ Hosp, Ctr Thrombosis & Hemostasis, Malmo, Sweden

[2] Lund Univ, Dept Clin Sci, Lund, Sweden

[3] Royal Hosp Children, Dept Haematol, Glasgow, Lanark, Scotland

[4] Sheba Med Ctr, Natl Hemophilia Ctr, Tel Hashomer, Israel

[5] Tel Aviv Univ, Sackler Sch Med, Tel Aviv, Israel

[6] Univ Helsinki, Helsinki Univ Hosp, Comprehens Canc Ctr, Childrens Hosp & Hematol, Helsinki, Finland

[7] Children Hosp La Timone, AP HM, Pediat Haematol Oncol Dept, Marseille, France

[8] Aix Marseille Univ, INSERM, INRA, C2VN,Fac Med, Marseille, France

[9] Hosp Vail dHebron, Unitat Hemofilia, Barcelona, Spain

[10] Hosp Univ La Paz, Unidad Coagulopatias, Madrid, Spain

[11] Prof Hess Kinderklin, Klinikum Bremen Mine, Gesundheit Nord, Bremen, Germany

[12] PedNet Haemophilia Res Fdn, Baarn, Netherlands

[13] Aix Marseille Univ, Children Hosp La Timone, AP HM, Pediat Haematol Oncol Dept, Marseille, France

[14] Hosp Univ & Politecn La Fe, Unidad Hemostasia & Trombosis, Valencia, Spain

[15] CHU Toulouse, Ctr Reg Hemophilie, Toulouse, France

[16] HZRM Hamophilie Zentrum Rhein Main GmbH, Morfelden Walldorf, Germany

[17] Univ Med Ctr Utrecht, Van Creveld Klin, Utrecht, Netherlands

[18] Katholieke Univ Leuven, Serv Pediat Haematol, Campus Gasthuisberg, Leuven, Belgium

[19] Univ Bern, Wabern & Childrens Hosp, Hamophiliezentrum, Bern, Switzerland

[20] JW Goethe Univ Hosp, Dept Pediat, Frankfurt, Germany

[21] Univ Munich, Dr V Haunersches Kinderspital, Munich, Germany

[22] Great Ormond St Hosp Sick Children, Hemophilia Ctr, Dept Haematol, London, England

[23] Skane Univ Hosp, Dept Pediat, Malmo, Sweden

[24] Skane Univ Hosp, Malmo Ctr Thrombosis & Haemostasis, Malmo, Sweden

[25] Helsinki Univ Cent Hosp, Childrens Hosp, Helsinki, Finland

[26] Univ Helsinki, Helsinki, Finland

[27] Osped Pediat Giannina Gaslini, Unita Trombosi & Emostasi, Dipartimento Ematol & Oncol, Genoa, Italy

[28] Univ Klin Kinder & Jugendheilkunde, Graz, Austria

[29] Our Ladys Childrens Hosp Sick Children, Dept Paediat Haematol, Dublin, Ireland

[30] Univ Klinikum Bonn, Inst Expt Hamatol & Transfus Med, Bonn, Germany

[31] Hosp Univ Virgen del Rocio, Hosp Gen Unidad Hemofilia, Seville, Spain

[32] St Sophia Childrens Hosp, Haemophilia Haemostasis Unit, Athens, Greece

[33] Hop Bicetre, Kremlin Bicetre AP HP, Ctr Reference Traitement Malad Hemorrag CRTH, Le Kremlin Bicetre, France

[34] Karolinska Hosp, Dept Pediat, Clin Coagulat Disorders, Stockholm, Sweden

[35] Osped Maggiore Policlin, IRCCS Ca Granda, Hemophilia & Thrombosis Ctr, Milan, Italy

[36] Univ Hosp Aarhus Skejby, Dept Pediat, Aarhus, Denmark

[37] Royal Hosp Sick Children, Edinburgh, Midlothian, Scotland

[38] Childrens Hosp, Dept Haematol, Birmingham, W Midlands, England

[39] Minist Hlth, Sheba Med Ctr, Natl Hemophilia Ctr, Tel Hashomer, Israel

[40] Hosp Sick Children, Div Haematol Oncol, Toronto, ON, Canada

[41] Hop St Justine, Div Hematol Oncol, Montreal, PQ, Canada

来源：

HAEMATOLOGICA | 2019年 / 104卷 / 10期

关键词：

AFFECTED INFANT; NEWBORNS; PREVALENCE; DIAGNOSIS; MORTALITY; LIFE;

D O I：

10.3324/haematol.2018.209619

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The optimal mode of delivery for a pregnant hemophilia carrier is still a matter of debate. The aim of the study was to determine the incidence of intracranial hemorrhage and other major bleeds in neonates with moderate and severe hemophilia in relationship to mode of delivery and known family history. A total of 926 neonates, 786 with severe and 140 with moderate hemophilia were included in this PedNet multicenter study. Vaginal delivery was performed in 68.3% (n=633) and Cesarean section in 31.6% (n=293). Twenty intracranial hemorrhages (2.2%) and 44 other major bleeds (4.8%) occurred. Intracranial hemorrhages occurred in 2.4% of neonates following vaginal delivery compared to 1.7% after Cesarean section (P=not significant); other major bleeds occurred in 4.2% born by vaginal delivery and in 5.8% after Cesarean section (P=not significant). Further analysis of subgroups (n=813) identified vaginal delivery with instruments being a significant risk factor for both intracranial hemorrhages and major bleeds (Relative Risk: 4.78-7.39; P<0.01); no other significant differences were found between vaginal delivery without instruments, Cesarean section prior to and during labor. There was no significant difference in frequency for intracranial hemorrhages and major bleeds between a planned Cesarean section and a planned vaginal delivery. Children with a family history of hemophilia (n=466) were more likely to be born by Cesarean section (35.8% vs. 27.6%), but no difference in the rate of intracranial hemorrhages or major bleeds was found. In summary, vaginal delivery and Cesarean section carry similar risks of intracranial hemorrhages and major bleeds. The 'PedNet Registry' is registered at clinicaltrials.gov identifier: 02979119.

引用

页码：2100 / 2106

页数：7

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