Zhang Jun, Meikle Susan, Trumble Ann
Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA.
Hypertens Pregnancy. 2003;22(2):203-12. doi: 10.1081/PRG-120021066.
This study was to report the incidence of severe maternal morbidity associated with hypertensive disorders of pregnancy in the United States.
We used data from the National Hospital Discharge Survey, a nationally representative sample of discharge records, from 1988 to 1997. The database consisted of approximately 300,000 deliveries, which represented 39 million births during the 10-year period.
The overall incidence of hypertensive disorders in pregnancy was 5.9% [95% confidence interval (CI): 5.2 to 6.5%]. Eclampsia was reported at 1.0 per 1,000 deliveries (95% CI: 0.8 to 1.2). The incidence of eclampsia, severe preeclampsia, and superimposed preeclampsia remained unchanged during the 10-year period. Women with preeclampsia and eclampsia had a 3- to 25-fold increased risk of severe complications, such as abruptio placentae, thrombocytopenia, disseminated intravascular coagulation, pulmonary edema, and aspiration pneumonia. More than half of women with preeclampsia and eclampsia had cesarean delivery. African American women not only had higher incidence of hypertensive disorders in pregnancy but also tended to have a greater risk for most severe complications. Preeclamptic and eclamptic women younger than 20 years or older than 35 years had substantially higher morbidity.
Preeclampsia and eclampsia carry a high risk for severe maternal morbidity. Compared to Caucasians, African Americans have higher incidence of hypertensive disorders in pregnancy and suffer from more severe complications.
本研究旨在报告美国与妊娠高血压疾病相关的严重孕产妇发病情况。
我们使用了来自国家医院出院调查的数据，该调查是1988年至1997年具有全国代表性的出院记录样本。数据库包含约300,000例分娩记录，代表了这10年期间的3900万例出生。
妊娠高血压疾病的总体发病率为5.9%[95%置信区间（CI）：5.2%至6.5%]。子痫的报告发病率为每1000例分娩1.0例（95%CI：0.8至1.2）。子痫、重度子痫前期和叠加子痫前期的发病率在这10年期间保持不变。患有子痫前期和子痫的女性发生严重并发症的风险增加了3至25倍，如胎盘早剥、血小板减少症、弥散性血管内凝血、肺水肿和吸入性肺炎。超过一半的子痫前期和子痫女性进行了剖宫产。非裔美国女性不仅妊娠高血压疾病的发病率较高，而且大多数严重并发症的风险也往往更大。年龄小于20岁或大于35岁的子痫前期和子痫女性的发病率显著更高。
子痫前期和子痫会导致严重的孕产妇发病风险。与白人相比，非裔美国女性妊娠高血压疾病的发病率更高，且并发症更严重。
