Lydakis C, Beevers M, Beevers D G, Lip G Y
University Department of Medicine, City Hospital, Birmingham.
Int J Clin Pract. 2001 Jul-Aug;55(6):361-7.
To study the prevalence of pre-eclampsia (PE) and other obstetric outcomes (growth restriction and fetal mortality) in pregnancies of normotensive and hypertensive women attending an antenatal hypertension clinic, we studied a cohort of 372 pregnancies from 267 women. The prevalence of PE in the groups of pregnancies of normotensive and chronic hypertensive women was 11.9% (19/159 cases) and 16.0% (34/213 cases) respectively (chi 2 = 1.2, p = 0.27). There were no significant differences in respect of ethnicity, being primi- or multigravida and smoking status or age. Treatment with antihypertensive drugs during pregnancy did not decrease the prevalence of PE. In pregnancies with hypertensive complications (with or without PE) there was a trend towards higher rates of pre-term delivery (< 37 weeks), caesarean section, small for gestational age babies, stillbirth and lower baby birth weight and ponderal index values. Pregnancies in women with uncomplicated hypertension had an increased risk for emergency caesarean section, pre-term delivery (< 37 weeks), birth weight < 2500 g and stillbirth (relative risks [with confidence intervals] 2.5 [1.9-3.2], 2.3 [1.8-2.9], 3.1 [2.5-3.7] and 5.5 [2.6-11.9] respectively) compared with the general hospital obstetric population. After classification according to the type of hypertensive syndrome, a progressively higher risk for fetal growth restriction and adverse perinatal outcome was shown in the hypertensive and pre-eclamptic groups. In chronic hypertension, this was irrespective of superimposed pre-eclampsia or antihypertensive therapy. The high prevalence of PE in chronic hypertensive women (16.0%) was not statistically significant to that of normotensive women (11.9%), reflecting the referral selection of 'high risk' normotensive women to our clinic.
为研究在产前高血压门诊就诊的血压正常和高血压孕妇中先兆子痫（PE）及其他产科结局（生长受限和胎儿死亡）的发生率，我们对267名女性的372例妊娠进行了队列研究。血压正常和慢性高血压孕妇组中PE的发生率分别为11.9%（19/159例）和16.0%（34/213例）（卡方 = 1.2，p = 0.27）。在种族、初产或经产状态、吸烟状况或年龄方面无显著差异。孕期使用降压药物并未降低PE的发生率。在有高血压并发症（无论有无PE）的妊娠中，早产（<37周）、剖宫产、小于胎龄儿、死产以及较低的出生体重和体重指数值的发生率有升高趋势。与综合医院产科人群相比，无并发症高血压女性的妊娠发生急诊剖宫产、早产（<37周）、出生体重<2500 g和死产的风险增加（相对风险[及其置信区间]分别为2.5[1.9 - 3.2]、2.3[1.8 - 2.9]、3.1[2.5 - 3.7]和5.5[2.6 - 11.9]）。根据高血压综合征类型分类后，高血压组和先兆子痫组胎儿生长受限及不良围产结局的风险逐渐升高。在慢性高血压中，这与是否合并先兆子痫或降压治疗无关。慢性高血压女性中PE的高发生率（16.0%）与血压正常女性（11.9%）相比无统计学意义，这反映了“高危”血压正常女性被转诊至我们诊所的选择情况。
