Colatrella A, Braucci S, Festa C, Bianchi P, Fallucca F, Mattei L, Trappolini M, Napoli A
Department of Clinical Sciences, S. Andrea Hospital, 2nd Faculty of Medicine, 'Sapienza' University of Rome, Rome, Italy.
Exp Clin Endocrinol Diabetes. 2009 Sep;117(8):373-7. doi: 10.1055/s-0029-1220763. Epub 2009 Jun 17.
Hypertension is one of the major complications of pregnancy. Its impact in type 2 diabetic pregnant women could be understimated because it is generally evaluated by retrospective studies and as one of the outcome measures.
Our aims were: 1) to evaluate the prevalence of hypertensive disease between type 2 diabetic and normal pregnancies; 2) to relate hypertensive disease to body weight in type 2 diabetic pregnancies; 3) to assess the impact of different types of hypertension on pregnancy outcome in type 2 diabetic women.
Seventy-six type 2 diabetic (23 normal-weight, 26 overweight and 27 obese) and sixty normal (43, 15 and 2 respectively; x (2) 0.0001) pregnancies, matched for age and smoking habit. Hypertension was defined as >/=140/90 mmHg and classified in chronic, gestational and pre-eclampsia.
Student's t-test, chi (2), simple, and/or multiple and logistic regression analysis were used when appropriate. Odds ratio was calculated for hypertension. p significant <0.05.
The overall prevalence of hypertension was 40.8% (18.4% chronic, 17.1% gestational and 5.3% pre-eclampsia) in type 2 diabetic pregnancies and 10% (8.3% gestational and 1.7% pre-eclampsia) in normal pregnancies (p<0.0001), with an odds ratio of 6.2. All the types of hypertension, significantly chronic, contributed to the higher prevalence. Only in diabetic pregnancies, hypertension was associated with a higher pregestational BMI; whenever BMI increased, chronic and gestational hypertension increased by contrast of pre-eclampsia (chi (2), 0.02). Hypertensive disorders did not affect maternal-fetal outcome.
The prevalence of hypertension was 40.8% in type 2 diabetic pregnant women whilst it was 10.0% in non diabetic controls. All hypertensive disorders, significantly chronic, were more frequent. Increasing BMI was a crucial factor for chronic and gestational but not for pre-eclampsia. Hypertensive diseases did not seem to affect pregnancy outcome.
高血压是妊娠的主要并发症之一。其在2型糖尿病孕妇中的影响可能被低估，因为通常是通过回顾性研究进行评估且作为结果指标之一。
我们的目标是：1）评估2型糖尿病孕妇与正常孕妇中高血压疾病的患病率；2）在2型糖尿病孕妇中将高血压疾病与体重相关联；3）评估不同类型的高血压对2型糖尿病女性妊娠结局的影响。
76例2型糖尿病孕妇（23例体重正常、26例超重、27例肥胖）和60例正常孕妇（分别为43例、15例和2例；χ² 0.0001），根据年龄和吸烟习惯进行匹配。高血压定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg，并分为慢性高血压、妊娠期高血压和子痫前期。
适当情况下使用学生t检验、χ²检验、简单和/或多元及逻辑回归分析。计算高血压的比值比。p值<0.05具有统计学意义。
2型糖尿病孕妇中高血压的总体患病率为40.8%（慢性高血压18.4%、妊娠期高血压17.1%、子痫前期5.3%），正常孕妇中为10%（妊娠期高血压8.3%、子痫前期1.7%）（p<0.0001），比值比为6.2。所有类型的高血压，尤其是慢性高血压，导致了更高的患病率。仅在糖尿病孕妇中，高血压与孕前体重指数较高相关；随着体重指数增加，与子痫前期相比，慢性高血压和妊娠期高血压增加（χ²检验，0.02）。高血压疾病未影响母婴结局。
2型糖尿病孕妇中高血压的患病率为40.8%，而非糖尿病对照组为10.0%。所有高血压疾病，尤其是慢性高血压，更为常见。体重指数增加是慢性高血压和妊娠期高血压的关键因素，但不是子痫前期的关键因素。高血压疾病似乎未影响妊娠结局。
