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降压治疗对慢性和妊娠高血压孕妇的疗效:一项基于人群的研究。

The efficacy of antihypertensive treatment in pregnant women with chronic and gestational hypertension: a population-based study.

机构信息

Second Department of Obstetrics and Gynecology, School of Medicine, Semmelweis University, Budapest, Hungary.

出版信息

Hypertens Res. 2010 May;33(5):460-6. doi: 10.1038/hr.2010.17. Epub 2010 Feb 12.

Abstract

The efficacy of antihypertensive treatment was investigated in pregnant women with chronic hypertension (CH) or gestational hypertension (GH) on the basis of the occurrence of pregnancy complications and adverse birth outcomes. Medically recorded pregnancy complications and birth outcomes of 1579 pregnant women with CH and 1098 pregnant women with GH were compared to 34,633 pregnant women without CH, GH, preeclampsia-eclampsia or any secondary hypertension who delivered newborn infants without defects in the population-based data set of the Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996. Of 1579 (4.1%) pregnant women with CH, 1522 (96.4%) were treated with antihypertensive drugs. Of 1098 (2.9%) pregnant women with GH, 657 (59.8%) were treated. Pregnant women with treated CH had a higher risk of threatened abortion, preterm delivery, and placental disorders, in addition to low-birthweight newborns. However, pregnant women with untreated CH and GH had no higher risk of pregnancy complications or adverse pregnancy outcomes. Antihypertensive treatments were not able to neutralize the harm of severe CH in pregnant women, the antihypertensive treatments were not appropriate and/or effective, or related drug treatments may contribute to these adverse effects.

摘要

本研究旨在基于妊娠并发症和不良母婴结局的发生情况,调查降压治疗在慢性高血压(CH)或妊娠期高血压(GH)孕妇中的疗效。将匈牙利先天性畸形病例对照监测系统 1980-1996 年的人群数据集中无 CH、GH、子痫前期-子痫或任何继发性高血压且新生儿无畸形的 34633 例孕妇作为对照组,与 1579 例 CH 孕妇(4.1%)和 1098 例 GH 孕妇(2.9%)的医源性妊娠并发症和母婴结局进行比较。1579 例 CH 孕妇中,1522 例(96.4%)接受了降压药物治疗,1098 例 GH 孕妇中,657 例(59.8%)接受了降压药物治疗。除了新生儿低体重外,接受降压治疗的 CH 孕妇发生先兆流产、早产和胎盘疾病的风险更高。然而,未经治疗的 CH 和 GH 孕妇并未增加妊娠并发症或不良妊娠结局的风险。降压治疗未能减轻重度 CH 对孕妇的危害,可能是降压治疗不当或无效,或者相关药物治疗可能导致这些不良影响。

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