Yamada Takashi, Kuwata Tomoyuki, Matsuda Hideo, Deguchi Keizo, Morikawa Mamoru, Yamada Takahiro, Furuya Kennichi, Matsubara Shigeki, Minakami Hisanori
Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Hypertens Pregnancy. 2012;31(2):268-77. doi: 10.3109/10641955.2011.638957. Epub 2011 Dec 9.
Recent findings suggest that cerebral edema is a characteristic finding on magnetic resonance imaging in women with eclampsia and that pregnancy-induced antithrombin deficiency (PIATD) may reflect enhanced vascular permeability and may allow the retention of excess water in the interstitial space. Whether PIATD and extraordinary weight gain (EOWG) are risk factors for eclampsia remains to be studied.
The medical records of 11 women with eclampsia among 17,522 deliveries were reviewed retrospectively with respect to changes in the laboratory data and the maternal body weight. PIATD was defined as a perinatal antithrombin activity of ≤65% of the normal activity levels with an antenatal decline and/or a prompt postnatal increase. A large net weight gain during the last two antenatal weeks >97.5th percentile value (>4.01 kg) obtained from 272 control women with neither hypertension nor PIATD was defined as EOWG. Relative risk was obtained on the assumption that the prevalences of PIATD and EOWG were 2.0 and 2.5%, respectively, among 17,511 women who did not develop eclampsia.
The duration of hypertension until an eclamptic fit was within 7 days in all 11 cases. PIATD and EOWG were observed in 6 (54.5%) and 2 (18.2%) cases, yielding a relative risk (95% confidential interval) of 57.9 (17.7-188.7) and 8.65 (1.87-39.91) for eclampsia among women with PIATD and EOWG, respectively.
PIATD and EOWG may be risk factors for eclampsia.
最近的研究结果表明，脑水肿是子痫女性磁共振成像的特征性表现，而妊娠诱导的抗凝血酶缺乏（PIATD）可能反映血管通透性增强，并可能导致间质间隙中多余水分的潴留。PIATD和超常体重增加（EOWG）是否为子痫的危险因素仍有待研究。
回顾性分析17522例分娩中11例子痫女性的病历，观察实验室数据和孕妇体重的变化。PIATD定义为围产期抗凝血酶活性≤正常活性水平的65%，且产前下降和/或产后迅速升高。将末次产前两周内体重净增加超过272例无高血压和PIATD的对照女性的第97.5百分位数（>4.01 kg）定义为EOWG。假设在17511例未发生子痫的女性中，PIATD和EOWG的患病率分别为2.0%和2.5%，计算相对风险。
所有11例患者直至子痫发作的高血压持续时间均在7天内。6例（54.5%）患者出现PIATD，2例（18.2%）患者出现EOWG，PIATD和EOWG女性发生子痫的相对风险（95%置信区间）分别为57.9（17.7 - 188.7）和8.65（1.87 - 39.91）。
PIATD和EOWG可能是子痫的危险因素。
