慢性高血压的患病率、趋势和结局：全国分娩入院样本。
Prevalence, trends, and outcomes of chronic hypertension: a nationwide sample of delivery admissions.
机构信息
Division of Obstetric Anesthesia, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
出版信息
Am J Obstet Gynecol. 2012 Feb;206(2):134.e1-8. doi: 10.1016/j.ajog.2011.10.878. Epub 2011 Nov 7.
OBJECTIVE
We sought to define the prevalence, trends, and outcomes of primary and secondary chronic hypertension in a population-based sample of deliveries.
STUDY DESIGN
An estimated 56,494,634 deliveries were identified from the 1995 through 2008 Nationwide Inpatient Sample. The association of primary and secondary chronic hypertension with adverse fetal and maternal outcomes was evaluated using regression modeling and adjusted population-attributable fractions were calculated.
RESULTS
During the study period, the prevalence of primary and secondary hypertension increased from 0.90% in 1995 through 1996 to 1.52% in 2007 through 2008 (P for trend < .001) and from 0.07% to 0.24% (P for trend < .001), respectively. The population-attributable fraction for chronic hypertension was considerable for many maternal adverse outcomes, including acute renal failure (21%), pulmonary edema (14%), preeclampsia (11%), and in-hospital mortality (10%).
CONCLUSION
Primary and secondary chronic hypertension were both strongly associated with adverse pregnancy outcomes and accounted for a substantial fraction of maternal morbidity. Prioritizing research efforts in this area is needed.
目的
我们旨在确定原发性和继发性慢性高血压在基于人群的分娩样本中的流行率、趋势和结局。
研究设计
从 1995 年至 2008 年全国住院患者样本中确定了约 56494634 例分娩。使用回归模型评估原发性和继发性慢性高血压与不良胎儿和产妇结局的关系，并计算调整后的人群归因分数。
结果
在研究期间，原发性和继发性高血压的患病率从 1995 年至 1996 年的 0.90%增加到 2007 年至 2008 年的 1.52%（趋势 P<0.001），从 0.07%增加到 0.24%（趋势 P<0.001）。慢性高血压对许多产妇不良结局的人群归因分数相当高，包括急性肾衰竭（21%）、肺水肿（14%）、子痫前期（11%）和院内死亡率（10%）。
结论
原发性和继发性慢性高血压均与不良妊娠结局密切相关，并导致产妇发病率的很大一部分。需要在这一领域优先开展研究工作。
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