Ohkuchi Akihide, Iwasaki Ryuhiko, Suzuki Hirotada, Hirashima Chikako, Takahashi Kayo, Usui Rie, Matsubara Shigeki, Minakami Hisanori, Suzuki Mitsuaki
Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, Japan.
Hypertens Res. 2006 Mar;29(3):161-7. doi: 10.1291/hypres.29.161.
Blood pressure (BP) levels and body mass index (BMI) are known as risk factors for preeclampsia and gestational hypertension. However, there have been few investigations regarding the effects of BP and BMI levels on preeclampsia and gestational hypertension in the same cohort. In the present study, we conducted a retrospective cohort study using multiple logistic regression analysis. The cohort included 1,518 patients without nephritis. The unadjusted odds ratios (ORs) of preeclampsia and gestational hypertension were increased in pregnant women with normal BP (120-129 mmHg systolic or 80-84 mmHg diastolic), high-normal BP and hypertension in the second trimester compared to those with optimal BP. The unadjusted ORs of preeclampsia and gestational hypertension were also increased in obese women in the pre-pregnancy period compared to women with normal range BMI. When adjustment was made for both the BP levels and pre-pregnancy BMI levels, the ORs (95% confidence intervals) of normal BP, high-normal BP, hypertension and obesity for the subsequent occurrence of preeclampsia were 5.1 (2.2-12), 8.3 (3.1-22), 16 (5.0-50) and 2.0 (0.67-5.9), and those for the subsequent occurrence of gestational hypertension were 7.0 (2.6-19), 7.4 (2.1-25), 22 (6.1-83) and 1.3 (0.33-4.8), respectively. For the subsequent occurrence of preeclampsia or gestational hypertension, normal BP, high-normal BP and hypertension in the second trimester may be independent risk factors. Obesity in the pre-pregnancy period, however, may not be an independent risk factor.
血压（BP）水平和体重指数（BMI）是已知的子痫前期和妊娠期高血压的危险因素。然而，关于同一队列中BP和BMI水平对子痫前期和妊娠期高血压影响的研究较少。在本研究中，我们使用多因素逻辑回归分析进行了一项回顾性队列研究。该队列包括1518例无肾炎患者。与血压最佳的孕妇相比，收缩压正常（120 - 129 mmHg）或舒张压正常（80 - 84 mmHg）、血压高正常及孕中期高血压的孕妇发生子痫前期和妊娠期高血压的未调整比值比（OR）升高。与BMI在正常范围的女性相比，孕前肥胖女性发生子痫前期和妊娠期高血压的未调整OR也升高。当对血压水平和孕前BMI水平进行调整后，正常血压、高正常血压、高血压和肥胖导致后续发生子痫前期的OR（95%置信区间）分别为5.1（2.2 - 12）、8.3（3.1 - 22）、16（5.0 - 50）和2.0（0.67 - 5.9），导致后续发生妊娠期高血压的OR分别为7.0（2.6 - 19）、7.4（2.1 - 25）、22（6.1 - 83）和1.3（0.33 - 4.8）。对于后续发生子痫前期或妊娠期高血压，孕中期正常血压、高正常血压和高血压可能是独立危险因素。然而，孕前肥胖可能不是独立危险因素。
