Division of Maternal Fetal Medicine, Ultrasound and Genetics, Department of Obstetrics and Gynecology, Washington University School of Medicine, St Louis, MO 63110, USA.
Prenat Diagn. 2010 Jan;30(1):9-13. doi: 10.1002/pd.2410.
Our objective is to evaluate for potential associations between chorionic villus sampling (CVS) and hypertensive disorders of pregnancy.
Using our genetic database, we compared the rates of hypertensive disorders between women who underwent CVS at 10-13 and 6/7 weeks with those seen for other indications at similar gestational ages who had no invasive procedure. Only singleton and euploid pregnancies were included. Statistical methods including univariable and multivariable logistic regression, supplemented by stratified analyses were used for comparisons.
Among 11 012 pregnant women seen between 1990 and 2006 in our center and meeting the inclusion criteria, information on hypertensive disorders of pregnancy were available in 9386, and 9098 met the inclusion criteria. The overall incidence of hypertensive disorders was 421/9098 (4.6%), with 138/5096 (2.7%) in the CVS group and 283/4002 (7.1%) in the control group [adjusted odds ratio (adjOR) 0.47, 95% confidence interval (CI), 0.38-0.59]. Similar findings were seen on stratified analyses for gestational age of procedure and the type or severity of hypertensive disorder, and other potential confounders.
The rate of hypertensive disorders of pregnancy is significantly lower in women having CVS compared with the control group. Placental disruption from CVS is not associated with preeclampsia or gestational hypertension.
评估绒毛膜绒毛取样(CVS)与妊娠高血压疾病之间的潜在关联。
利用我们的基因数据库,比较了在 10-13 周和 6/7 周行 CVS 的女性与在相似孕龄因其他指征行无侵袭性操作的女性中高血压疾病的发生率。仅纳入单胎和整倍体妊娠。采用单变量和多变量逻辑回归等统计方法进行比较,并进行分层分析。
在我们中心于 1990 年至 2006 年间就诊的 11012 例孕妇中,符合纳入标准的有 9386 例,其中 9098 例符合纳入标准。妊娠高血压疾病的总发生率为 421/9098(4.6%),CVS 组为 138/5096(2.7%),对照组为 283/4002(7.1%)[校正比值比(adjOR)0.47,95%置信区间(CI)0.38-0.59]。在对操作时的孕龄和高血压疾病的类型或严重程度以及其他潜在混杂因素的分层分析中也观察到了类似的结果。
与对照组相比,行 CVS 的女性妊娠高血压疾病的发生率显著降低。CVS 导致的胎盘破坏与子痫前期或妊娠期高血压无关。