Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, China.
Chin Med J (Engl). 2010 Sep;123(18):2548-54.
This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science & Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy (HDP) and estimated the potential effect of anti-oxidants administration, including vitamin C (VC), vitamin E (VE) and Salvia Miltiorrhiza L (SML), a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy.
From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups: 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group.
(1) The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups (P > 0.05). (2) In anti-oxidants group, the HDP morbidities among three subgroups: VC + VE + SML, VC + VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies (P > 0.05). (3) The related index of factors affecting HDP showed in intensity sequence as follows: family HDP history > profession > education level > age > body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women (family HDP history, heavy physical labor, low education level (middle school and below), age ≥ 40, body mass index ≥ 24) was 5.84%, which was obviously higher than that in normal population (P < 0.01). In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% (P < 0.01). (4) In control group, the morbidity of HDP in women with family HDP history (especially with sisters'), heavy physical labor, middle school and below, age ≥ 35 was: 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group.
The high-risk factors prone to induce HDP included: family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.
本研究为多中心、大样本的前瞻性临床研究，隶属国家“十五”攻关课题。分析妊娠高血压疾病（HDP）的高危因素，并评估抗氧化剂（维生素 C、维生素 E 和丹参）对高危因素的改善作用。
2005 年 4 月至 2006 年 7 月，全国 24 家协作医院共 4814 例孕妇入选，随机分为抗氧化剂组（1607 例）和对照组（3207 例）。抗氧化剂组给予维生素 C、维生素 E 和丹参治疗，对照组不用药。观察两组 HDP 发生率及高危因素。
（1）抗氧化剂组 HDP 发生率为 3.55%，对照组为 4.18%，两组比较差异无统计学意义（P＞0.05）。（2）抗氧化剂组中 VC+VE+SML、VC+VE、SML 亚组 HDP 发生率分别为 5.51%、3.05%、5%，组间比较差异无统计学意义（P＞0.05）。（3）HDP 高危因素强度依次为：家族史、职业、文化程度、年龄、体重。普通人群 HDP 发生率为 3.51%，高危人群（家族史、体力劳动、文化程度低、年龄≥40 岁、BMI≥24）HDP 发生率为 5.84%，明显高于普通人群（P＜0.01）。抗氧化剂组高危人群 HDP 发生率为 3.81%，明显低于对照组高危人群的 7.14%（P＜0.01）。（4）对照组家族史（尤其是姐妹）、体力劳动、文化程度低、年龄≥35 岁的孕妇 HDP 发生率分别为 50.00%、15.22%、6.33%、26.28%、5.75%，抗氧化剂组分别为 0、7.69%、3.74%、9.27%、2.67%，明显低于对照组。
HDP 的高危因素包括家族史、体力劳动、文化程度低、高龄和肥胖。抗氧化剂对普通人群 HDP 的预防作用不明显，但对高危人群有一定的预防作用。
