Williams Keith P, Wilson Susan
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT, USA.
J Obstet Gynaecol Can. 2002 Jun;24(6):485-9. doi: 10.1016/s1701-2163(16)31096-9.
To determine whether maternal and fetal complications such as HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome and the incidence of small for gestational age infants in women with preeclampsia and gestational hypertension differ with both gravidity and parity.
The charts of 441 hypertensive women, 182 with preeclampsia and 259 with gestational hypertension, presenting for delivery at B.C. Women's Hospital were retrospectively reviewed. Multiple clinical parameters, including gestational age at presentation, the incidence of small for gestational age (SGA) infants, HELLP syndrome, and the severity of pre-eclampsia, were compared among three groups of women: (A) primigravid primiparous, (B) multigravid primiparous, and (C) multiparous. Mean values between the groups were compared using analysis of variance with pair-wise comparison using the Tukey test.
The incidence of HELLP syndrome among the women with preeclampsia was similar in groups A and B (35% and 50%, respectively), but significantly lower (p < 0.012) in group C (19%). The incidence of small for gestational age infants among the women with preeclampsia was similar for groups A, B, and C (27%, 31%, and 19%, respectively). In the gestational hypertensive group the incidence of SGA infants was similar for groups A, B, and C (14%, 11%, and 12% respectively).
The preeclamptic primigravid primiparous and multigravid primiparous groups behaved similarly in their clinical expression of hypertensive complications but differed from the multiparous group by having a higher incidence of HELLP syndrome. The incidence of complications in hypertensive pregnant women varied by parity but not by gravidity. The gestational hypertensive groups did not differ in their clinical expression of hypertensive complications.
确定子痫前期和妊娠高血压妇女中，诸如HELLP（溶血、肝酶升高、血小板减少）综合征等母婴并发症以及小于胎龄儿的发生率是否因孕次和产次不同而有所差异。
对在不列颠哥伦比亚省妇女医院分娩的441名高血压妇女的病历进行回顾性分析，其中182名为子痫前期患者，259名为妊娠高血压患者。比较了三组妇女的多个临床参数，包括就诊时的孕周、小于胎龄（SGA）儿的发生率、HELLP综合征以及子痫前期的严重程度：（A）初孕初产，（B）经孕初产，（C）经产妇。组间均值比较采用方差分析，并使用Tukey检验进行两两比较。
子痫前期妇女中，HELLP综合征的发生率在A组和B组相似（分别为35%和50%），但在C组显著更低（p < 0.012），为19%。子痫前期妇女中，小于胎龄儿的发生率在A组、B组和C组相似（分别为27%、31%和19%）。在妊娠高血压组中，小于胎龄儿的发生率在A组、B组和C组相似（分别为14%、11%和12%）。
子痫前期初孕初产组和经孕初产组在高血压并发症的临床表现上相似，但与经产妇组不同，HELLP综合征的发生率更高。高血压孕妇并发症的发生率因产次而异，而非孕次。妊娠高血压组在高血压并发症的临床表现上没有差异。
