Kuklina Elena V, Ayala Carma, Callaghan William M
From Northrop Grumman, Civilian Agencies Group; the Division for Heart Disease and Stroke Prevention, and the Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.
Obstet Gynecol. 2009 Jun;113(6):1299-1306. doi: 10.1097/AOG.0b013e3181a45b25.
To examine trends in the rates of hypertensive disorders in pregnancy and compare the rates of severe obstetric complications for delivery hospitalizations with and without hypertensive disorders.
We performed a cross-sectional study using the 1998-2006 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Logistic regressions and population-attributable fractions were used to examine the effect of hypertensive disorders on severe complications.
The overall prevalence of hypertensive disorders among delivery hospitalizations increased significantly from 67.2 per 1,000 deliveries in 1998 to 81.4 per 1,000 deliveries in 2006. Compared with hospitalizations without any hypertensive disorders, the risk of severe obstetric complications ranged from 3.3 to 34.8 for hospitalizations with eclampsia/severe preeclampsia and from 1.4 to 2.2 for gestational hypertension. The prevalence of hospitalizations with eclampsia/severe preeclampsia increased moderately from 9.4 to 12.4 per 1,000 deliveries (P for linear trend <0.001) during the period of study. However, these hospitalizations were associated with 38% of hospitalizations with acute renal failure and 19% or more of hospitalizations with ventilation, disseminated intravascular coagulation syndrome, pulmonary edema, puerperal cerebrovascular disorders, and respiratory distress syndrome. Overall, hospitalizations with hypertensive disorders were associated with 57% of hospitalizations with acute renal failure, 27% of hospitalizations with disseminated intravascular coagulation syndrome, and 30% or more of hospitalizations with ventilation, pulmonary edema, puerperal cerebrovascular disorders, and respiratory distress syndrome.
The number of delivery hospitalizations in the United States with hypertensive disorders in pregnancy is increasing, and these hospitalizations are associated with a substantial burden of severe obstetric morbidity.
III.
研究妊娠期高血压疾病发生率的变化趋势，并比较有和没有高血压疾病的分娩住院严重产科并发症的发生率。
我们使用1998 - 2006年医疗成本和利用项目的全国住院患者样本进行了一项横断面研究。采用逻辑回归和人群归因分数来研究高血压疾病对严重并发症的影响。
分娩住院中高血压疾病的总体患病率从1998年每1000例分娩中的67.2例显著增加到2006年每1000例分娩中的81.4例。与没有任何高血压疾病的住院相比，子痫/重度子痫前期住院的严重产科并发症风险为3.3至34.8，妊娠期高血压住院的严重产科并发症风险为1.4至2.2。在研究期间，子痫/重度子痫前期住院的患病率从每1000例分娩中的9.4例适度增加到12.4例（线性趋势P<0.001）。然而，这些住院与38%的急性肾衰竭住院以及19%或更多的通气、弥散性血管内凝血综合征、肺水肿、产褥期脑血管疾病和呼吸窘迫综合征住院相关。总体而言，高血压疾病住院与57%的急性肾衰竭住院、27%的弥散性血管内凝血综合征住院以及30%或更多的通气、肺水肿、产褥期脑血管疾病和呼吸窘迫综合征住院相关。
美国妊娠期高血压疾病的分娩住院数量正在增加，并且这些住院与严重产科发病率的沉重负担相关。
III级。
Zotero 插件