{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T05:00:00Z","timestamp":1771477200875,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2016,12,15]],"date-time":"2016-12-15T00:00:00Z","timestamp":1481760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2017,10]]},"abstract":"Objective<\/jats:title>To assess if pregnancies among women with Addison's disease (AD<\/jats:styled-content>) are at higher risk of adverse maternal and neonatal outcomes.<\/jats:p><\/jats:sec>Design<\/jats:title>Population\u2010based retrospective cohort study.<\/jats:p><\/jats:sec>Setting\/Population<\/jats:title>All births in the United States\u2019 Healthcare Cost and Utilization Project\u2010Nationwide Inpatient Sample from 2003 to 2011.<\/jats:p><\/jats:sec>Methods<\/jats:title>Baseline characteristics were compared between women with AD<\/jats:styled-content> and those without, and prevalence over time was measured. Logistic regression was used to estimate the effect of AD<\/jats:styled-content> on maternal and neonatal outcomes by calculating the crude and adjusted odds ratios (OR<\/jats:styled-content>) and corresponding 95% confidence intervals (95% CI<\/jats:styled-content>).<\/jats:p><\/jats:sec>Results<\/jats:title>We calculated a prevalence of AD<\/jats:styled-content> in pregnancy of 5.5\/100 000, increasing from 5.6 to 9.6\/100 000 (P<\/jats:italic> = 0.0001) over the 9\u2010year study period. Compared with women without AD<\/jats:styled-content>, women with AD<\/jats:styled-content> were more likely to deliver preterm (OR<\/jats:styled-content> 1.50, 95% CI<\/jats:styled-content> 1.16\u20131.95), deliver by caesarean section (OR<\/jats:styled-content> 1.32, 95% CI<\/jats:styled-content> 1.08\u20131.61), have impaired wound healing (OR<\/jats:styled-content> 4.28, 95% CI<\/jats:styled-content> 2.55\u20137.18), develop infections (OR<\/jats:styled-content> 2.44, 95% CI<\/jats:styled-content> 1.66\u20133.58) and develop thromboembolism (OR<\/jats:styled-content> 5.21, 95% CI<\/jats:styled-content> 2.15\u201312.63), require transfusions (OR<\/jats:styled-content> 6.69, 95% CI<\/jats:styled-content> 4.69\u20139.54), and have prolonged postpartum hospital admissions (OR<\/jats:styled-content> 5.71, 95% CI<\/jats:styled-content> 4.37\u20137.47). Maternal mortality was significantly higher than in the comparison group (OR<\/jats:styled-content> 22.30, 95% CI<\/jats:styled-content> 6.82\u201372.96). Congenital anomalies (OR<\/jats:styled-content> 3.62, 95% CI<\/jats:styled-content> 2.05\u20136.39) and small\u2010for\u2010gestational age infants (OR<\/jats:styled-content> 1.78, 95% CI<\/jats:styled-content> 1.15\u20132.75) were more likely in these pregnancies.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Addison's disease significantly increases the risk of severe adverse maternal and neonatal outcomes, so pregnant women with AD<\/jats:styled-content> are best managed in tertiary\u2010care centres.<\/jats:p><\/jats:sec>Tweetable abstract<\/jats:title>Pregnancies complicated by Addison's disease have an increased risk of adverse maternal and neonatal outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1471-0528.14448","type":"journal-article","created":{"date-parts":[[2016,12,17]],"date-time":"2016-12-17T11:55:59Z","timestamp":1481975759000},"page":"1772-1779","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Maternal and neonatal outcomes of pregnancies in women with Addison's disease: a population\u2010based cohort study on 7.7 million births"],"prefix":"10.1111","volume":"124","author":[{"given":"M","family":"Schneiderman","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynaecology Jewish General Hospital Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N","family":"Czuzoj\u2010Shulman","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AR","family":"Spence","sequence":"additional","affiliation":[{"name":"Centre for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"HA","family":"Abenhaim","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Jewish General Hospital Montreal QC Canada"},{"name":"Centre for Clinical Epidemiology and Community Studies Jewish General Hospital Montreal QC Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,12,15]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2004-0025"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.84.5.1762"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13492-7"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12162"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2009.01.010"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAJ.0b013e31828aaeee"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.5761.566"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/01443619750113285"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archfami.9.3.284"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2010-0108"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03347034"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2011.08.004"},{"key":"e_1_2_6_14_1","first-page":"199","article-title":"Addison's disease, with successful pregnancy outcome","volume":"23","author":"Donnelly JC","year":"2003","journal-title":"J Obstet Gynaecol"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2003.01.001"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2004-820912"},{"key":"e_1_2_6_17_1","first-page":"53","article-title":"Addison's disease and pregnancy: case report","volume":"3","author":"Cosimo C","year":"2009","journal-title":"J Prenat Med"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/cen.12097"},{"key":"e_1_2_6_19_1","first-page":"62","article-title":"On birth weight and gestation period in infants born to mothers with Addison's disease","volume":"18","author":"Hilden J","year":"1971","journal-title":"Dan Med Bull"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.3109\/01443615.2011.563330"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1520-6661(199805\/06)7:3<154::AID-MFM10>3.0.CO;2-H"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.4103\/2230-8210.95747"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-1"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3740"},{"key":"e_1_2_6_25_1","unstructured":"Healthcare Cost and Utilization Project.HCUP Quality Control Procedures. 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