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妊娠前心脏代谢和炎症危险因素与妊娠高血压疾病的后续风险。

Prepregnancy cardiometabolic and inflammatory risk factors and subsequent risk of hypertensive disorders of pregnancy.

机构信息

Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612-2304, USA.

出版信息

Am J Obstet Gynecol. 2012 Jul;207(1):68.e1-9. doi: 10.1016/j.ajog.2012.05.017. Epub 2012 May 23.

Abstract

OBJECTIVE

The purpose of this study was to examine prepregnancy cardiometabolic and inflammatory markers and the subsequent risk of hypertensive disorders of pregnancy.

STUDY DESIGN

This was a retrospective cohort study of 3380 women who took part in a comprehensive multiphasic health checkup (MHC) examination between 1984 and 1996 and who subsequently delivered at Kaiser Permanente Northern California.

RESULTS

Two hundred five women were diagnosed with a hypertensive disorder of pregnancy. Prepregnancy measurements of overweight/obesity (body mass index, ≥25.0 kg/m(2)), prehypertension, and inflammation (leukocytes, ≥7.2 10(3)/μL) were associated independently with hypertensive disorder of pregnancy risk (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2-2.3; OR, 2.1; 95% CI, 1.5-2.8; and OR, 1.6; 95% CI, 1.1-2.3, respectively). Being overweight/obese and having prehypertension before pregnancy was associated with a 3.5-fold increased risk of hypertensive disorder of pregnancy compared with women with normal levels of both risk factors.

CONCLUSION

A prepregnancy cardiometabolic and inflammation risk profile may help clinicians identify high-risk women to target for early intervention or management of hypertensive disorder of pregnancy.

摘要

目的

本研究旨在探讨妊娠前心血管代谢和炎症标志物与妊娠高血压疾病风险之间的关系。

研究设计

这是一项回顾性队列研究,共纳入 3380 名于 1984 年至 1996 年间在 Kaiser Permanente Northern California 接受全面多相健康检查(MHC)的女性,且这些女性随后均在该机构分娩。

结果

共有 205 名女性被诊断为妊娠高血压疾病。妊娠前超重/肥胖(体质量指数,≥25.0kg/m²)、高血压前期和炎症(白细胞,≥7.2×10³/μL)的测量值与妊娠高血压疾病风险独立相关(比值比[OR],1.6;95%置信区间[CI],1.2-2.3;OR,2.1;95%CI,1.5-2.8;OR,1.6;95%CI,1.1-2.3)。与两种危险因素水平均正常的女性相比,妊娠前超重/肥胖和高血压前期与妊娠高血压疾病风险增加 3.5 倍相关。

结论

妊娠前心血管代谢和炎症风险谱可能有助于临床医生识别高危女性,以便针对妊娠高血压疾病进行早期干预或管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/223f/4161150/24414a893fd6/nihms380486f1.jpg

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