| مستخلص: |
Introduction: Syncope is a common presentation in the general population, particularly among women of child-bearing age. However, little is known about the incidence of syncope during pregnancy and whether it impacts neonatal outcomes. Accordingly, we examined these issues in a large, contemporary, population-based, pregnancy-birth cohort. Methods: The longitudinal Alberta Pregnancy-Birth cohort consists of all live births between January 1, 2005 and December 31, 2014 in the province of Alberta, Canada. This defined geographic area has a single-payer health care system with universal access and 100% capture of all interactions with the health care system. Inpatient and outpatient (clinic, emergency department, or physician office) administrative health records were used to identify women with a syncope episode during pregnancy. The unit of analysis was the pregnancy and women with multiple pregnancies during the study period are included more than once. Pregnancies were categorized according to the timing of their first (index) syncope episode (first, second, or third trimester). Primary outcomes of interest were rates of preterm birth and having small for gestational age (SGA) infants. Results: Among a total of 481,930 pregnancies, 4,667 (1.0%) women had a syncope event. Of these 1,506 (32.3%) had their index syncope in the first trimester, 2,058 (44.1%) in the second trimester, and 1,103 (23.6%) in the third trimester. Compared to women without syncope, women who experienced syncope were younger (age<25 years; 34.7% vs. 20.8%), and more likely nulliparous (52.1% vs. 42.4%). The rates of preterm birth (<37 weeks gestation) as well as SGA were higher in women with syncope during the first and second trimester compared to women without syncope (Figure). Conclusions: In this large cohort of women with universal health coverage, we found the incidence of syncope during pregnancy was relatively low. However, if syncope occurs, particularly in the first semester of pregnancy, it may identify women at a higher risk for adverse neonatal outcomes. [ABSTRACT FROM AUTHOR] |
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