Merviel P, Touzart L, Deslandes V, Delmas M, Coicaud M, Gondry J
Service de gynécologie-obstétrique et médecine de la reproduction, CHU d'Amiens, 124, rue Camille-Desmoulins, 80054 Amiens cedex 1, France.
J Gynecol Obstet Biol Reprod (Paris). 2008 Sep;37(5):477-82. doi: 10.1016/j.jgyn.2008.04.001. Epub 2008 May 23.
Study of the clinical risk factors of preeclampsia during a single pregnancy.
Retrospective case-control study during five years.
One hundred and eighty-eight cases of preeclampsia have been studied, with 147 called severe (78.2%). We find as risk factors: first pregnancy (OR=2.11; IC 95% [1.30-3.35]), primiparity (OR=2.67; IC 95% [1.67-4.29]), primipaternity (OR=3.55; IC 95% [2.13-5.83], maternal overweight (OR=2.50; IC 95% [1.55-4.05]), personal history of preeclampsia (OR=8.12; IC 95% [2.37-45.65]), personal history of hypertension (OR=2.77; IC 95% [1.01-7.99]), familial history of preeclampsia (OR=1.04; IC 95% [1.01-1.08]), familial history of hypertension at the first step (OR=2.61; IC 95% [1.32-5.47]). Two elements have been found as protected: tobacco before pregnancy (OR=0.51; IC 95% [0.36-0.85]), tobacco during pregnancy (OR=0.52; IC 95% [0.30-0.92]).
Preeclampsia is responsible of a high maternal and fetal morbidity. The risk factors are widespread, the only use of them is not enough to determine the individual risk. A second step could be to determine if biological markers are better than clinical factors.
研究单胎妊娠子痫前期的临床危险因素。
为期五年的回顾性病例对照研究。
对188例子痫前期病例进行了研究，其中147例为重度子痫前期（78.2%）。我们发现的危险因素有：初孕（比值比=2.11；95%置信区间[1.30 - 3.35]）、初产（比值比=2.67；95%置信区间[1.67 - 4.29]）、初为人父（比值比=3.55；95%置信区间[2.13 - 5.83]）、孕妇超重（比值比=2.50；95%置信区间[1.55 - 4.05]）、子痫前期个人史（比值比=8.12；95%置信区间[2.37 - 45.65]）、高血压个人史（比值比=2.77；95%置信区间[1.01 - 7.99]）、子痫前期家族史（比值比=1.04；95%置信区间[1.01 - 1.08]）、一级高血压家族史（比值比=2.61；95%置信区间[1.32 - 5.47]）。发现有两个因素具有保护作用：孕前吸烟（比值比=0.51；95%置信区间[0.36 - 0.85]）、孕期吸烟（比值比=0.52；95%置信区间[0.30 - 0.92]）。
子痫前期会导致较高的孕产妇和胎儿发病率。危险因素广泛存在，仅依据这些因素不足以确定个体风险。下一步可以确定生物标志物是否比临床因素更具优势。
