Department of Obstetrics and Gynecology, Hjorring Central Hospital, Hjorring, Denmark.
Arch Gynecol Obstet. 2011 Mar;283(3):443-7. doi: 10.1007/s00404-010-1371-y. Epub 2010 Feb 5.
Pregnancy-induced hypertension and preeclampsia are serious clinical manifestations during late pregnancy and the cause for increased maternal and foetal morbidity and mortality. The pathogenesis is unknown but experience from treatment schemes suggests that minerals may be of importance. Mineral homeostasis is influenced by acid-base conditions. The aim of the study was to elucidate the relation between acid-base balance, urinary mineral excretion and blood pressure during pregnancy.
A prospective observational study of a general population.
The study was performed at the Midwife Health Center in Borås, Sweden, where practically all pregnant subjects in the catchment area are registered. First time pregnant subjects (n = 123) were voluntarily recruited without exclusion criteria. A 24 h urine sample was collected at pregnancy week 12 and analyzed for creatinine, calcium, magnesium, and urea as a proxy for acid conditions. Blood pressure was recorded every 2-3 weeks until delivery.
There was a relation between the excretion of urea and calcium and magnesium at week 12. A blood pressure increase was found after pregnancy week 30 but only among subjects who had a high excretion of calcium and magnesium at week 12.
If an increase in blood pressure during the later part of pregnancy a risk indicator for preeclampsia, the results suggest that an excessive secretion of calcium leading to a functional deficit might be a risk indicator for gestational hypertension and preeclampsia. Intervention experiments are required to assess this hypothesis.
妊娠高血压和子痫前期是妊娠晚期的严重临床表现，也是导致母婴发病率和死亡率增加的原因。其发病机制尚不清楚，但从治疗方案的经验来看，矿物质可能很重要。矿物质的动态平衡受酸碱条件的影响。本研究的目的是阐明妊娠期间酸碱平衡、尿矿物质排泄与血压之间的关系。
对一般人群进行前瞻性观察研究。
该研究在瑞典博尔拉斯的助产士健康中心进行，该中心所在的区域几乎所有的孕妇都在其登记范围内。首次怀孕的孕妇（n=123）自愿招募，无排除标准。在妊娠第 12 周收集 24 小时尿液样本，分析肌酐、钙、镁和尿素，以作为酸碱条件的替代指标。直至分娩前，每 2-3 周记录一次血压。
在第 12 周时，尿中尿素和钙镁的排泄之间存在关系。在妊娠 30 周后发现血压升高，但仅在第 12 周时钙和镁排泄量较高的孕妇中发现。
如果妊娠后期血压升高是子痫前期的一个风险指标，那么这些结果表明，钙的过度分泌导致功能缺陷可能是妊娠高血压和子痫前期的一个风险指标。需要进行干预实验来评估这一假设。
