Chen Yi-Yung, Wu Mao-Lin, Kao Mei-Hua, Su Tsung-Hsien, Chen Chie-Pein
Division of High Risk Pregnancy, Mackay Memorial Hospital, Taipei, Taiwan.
J Obstet Gynaecol Res. 2009 Dec;35(6):1042-6. doi: 10.1111/j.1447-0756.2009.01057.x.
The aim of the study was to compare the perinatal outcome of recurrent pre-eclampsia in multiparas with that of pre-eclampsia in nulliparas.
This retrospective study was performed by collecting maternal and perinatal data from records of women with pre-eclampsia who delivered at Mackay Memorial Hospital over a 10-year period. Fifty women with recurrent pre-eclampsia were compared with 207 women who developed pre-eclampsia as nulliparas. In the 50 multiparas, the outcome of recurrent pre-eclampsia was also compared with that of their earlier episodes of pre-eclampsia. Maternal and fetal variables compared included maternal blood pressure, serum biochemistry, rate of preterm delivery, rate of abruptio placentae and neonatal outcome.
Compared with nulliparous women with pre-eclampsia (n = 50), women with recurrent pre-eclampsia (n = 207) had a smaller increase in mean maternal blood pressure (27.0 +/- 18.9 mmHg vs 34.3 +/- 19.3 mmHg, P = 0.021), less dipstick proteinuria (>or=++; 36.0 vs 58.5%, P = 0.004), and bore children with a heavier mean birthweight (2909.1 +/- 895.5 g vs 2551.1 +/- 933.0 g, P = 0.017). No significant statistical difference was found in the gestational age of delivery, maternal serum biochemical levels and rate of abruptio placentae or preterm delivery. Within the multiparous group (n = 50), recurrent disease was associated with a lower mean maternal blood pressure and dipstick proteinuria and with higher birthweight than in their previous pre-eclamptic pregnancies.
Recurrent pre-eclampsia appears to be less severe and to have a better perinatal outcome than pre-eclampsia in nulliparas.
本研究旨在比较经产妇复发性子痫前期与初产妇子痫前期的围产期结局。
本回顾性研究通过收集10年间在马偕纪念医院分娩的子痫前期女性患者记录中的产妇和围产期数据进行。将50例复发性子痫前期患者与207例初发子痫前期的初产妇进行比较。在50例经产妇中，还将复发性子痫前期的结局与其早期子痫前期发作的结局进行了比较。比较的产妇和胎儿变量包括产妇血压、血清生化指标、早产率、胎盘早剥率和新生儿结局。
与初发性子痫前期的初产妇（n = 50）相比，复发性子痫前期患者（n = 207）的产妇平均血压升高幅度较小（27.0±18.9 mmHg对34.3±19.3 mmHg，P = 0.021），尿试纸蛋白尿较少（≥++; 36.0%对58.5%，P = 0.004），所生婴儿的平均出生体重较重（2909.1±895.5 g对2551.1±933.0 g，P = 0.017）。在分娩孕周、产妇血清生化水平、胎盘早剥率或早产率方面未发现显著统计学差异。在经产妇组（n = 50）中，与前次子痫前期妊娠相比，复发性疾病与较低的产妇平均血压和尿试纸蛋白尿以及较高的出生体重相关。
复发性子痫前期似乎比初产妇子痫前期病情较轻，围产期结局更好。
