Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN.
J Clin Hypertens (Greenwich). 2013 Sep;15(9):617-23. doi: 10.1111/jch.12116. Epub 2013 Apr 29.
The authors aimed to compare renal function by estimated glomerular filtration rate and albuminuria in 3 groups of women: nulliparous women, women with a history of normotensive pregnancies, and women with a history of at least one hypertensive pregnancy. Women who participated in the second Family Blood Pressure Program Study visit (2000-2004) and had serum creatinine and urine albumin measurements (n=3015) were categorized as having had no pregnancy lasting >6 months (n=341), having had only normotensive pregnancies (n=2199), or having had at least 1 pregnancy with hypertension (n=475) based on a standardized questionnaire. Women who reported having had at least one pregnancy with hypertension were significantly more likely to be hypertensive (75.6% vs 59.4%, P<.001), diabetic (34.2% vs 27.3%, P≤.001), and have higher body mass index (32.8 vs 30.5, P<.001) than those who reported normotensive pregnancies. There was a significantly greater risk of microalbuminuria (urine albumin-creatinine ratio >25 mg/g) in those who reported at least one pregnancy with hypertension (odds ratio, 1.37; confidence interval, 1.02-1.85; P=.04) than in those with normotensive pregnancies, after adjusting for risk factors for chronic kidney and cardiovascular disease. Hypertension in pregnancy is associated with an increased risk of future microalbuminuria.
未生育女性、有正常妊娠史的女性和至少有一次高血压妊娠史的女性。参加第二次家庭血压计划研究访问(2000-2004 年)且有血清肌酐和尿白蛋白测量值的女性(n=3015)根据标准化问卷分为无持续>6 个月的妊娠(n=341)、仅有正常妊娠史(n=2199)或至少有一次高血压妊娠史(n=475)。报告至少有一次高血压妊娠的女性更可能患有高血压(75.6% vs 59.4%,P<.001)、糖尿病(34.2% vs 27.3%,P≤.001)和更高的体重指数(32.8 vs 30.5,P<.001)比报告正常妊娠的女性。与有正常妊娠史的女性相比,报告至少一次高血压妊娠的女性发生微量白蛋白尿(尿白蛋白/肌酐比值>25mg/g)的风险显著更高(比值比,1.37;置信区间,1.02-1.85;P=.04),调整慢性肾病和心血管疾病的危险因素后仍然如此。妊娠高血压与未来发生微量白蛋白尿的风险增加有关。