Geyl C, Clouqueur E, Lambert J, Subtil D, Debarge V, Deruelle P
Pôle d'obstétrique, maternité Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille cedex, France.
Service de biostatistique et information médicale, hôpital Saint-Louis, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France.
Gynecol Obstet Fertil. 2014 Apr;42(4):229-33. doi: 10.1016/j.gyobfe.2014.01.008. Epub 2014 Feb 16.
Preeclampsia is one of the most frequent and most serious complications of pregnancy. Its occurrence is around 5% of the pregnancies. Its pathophysiology is complex and includes several hypotheses. Preeclampsia is inconsistently associated with intrauterine growth retardation (IUGR). The determinants that explain the variability of this association are unknown. The objective of our study was to identify in a population of French patients who had preeclampsia and/or HELLP syndrome, incidence and risk factors of IUGR to isolate specific characteristics of these women.
We studied 578 pregnant women treated for preeclampsia or HELLP syndrome according to the presence or absence of IUGR (database compiled since 1996). Comparisons between the groups were done with Wilcoxon test (quantitative data) or Fisher's exact test (qualitative data).
We found that pre-eclampsia appeared earlier and was more severe in the group with IUGR. In addition foetal issues were more defavorable when IUGR was associated with preeclampsia.
Combination of IUGR and pre-eclampsia or HELLP syndrome is a criterion of severity for both the mother and the fetus. Our data do not allow distinguishing physiopathological mechanism to explain these differences.
子痫前期是妊娠最常见且最严重的并发症之一。其发生率约为妊娠总数的5%。其病理生理学复杂,存在多种假说。子痫前期与胎儿生长受限(IUGR)的关联并不一致。解释这种关联变异性的决定因素尚不清楚。我们研究的目的是在患有子痫前期和/或HELLP综合征的法国患者群体中,确定IUGR的发生率和危险因素,以找出这些女性的特定特征。
我们根据是否存在IUGR,研究了578例因子痫前期或HELLP综合征接受治疗的孕妇(自1996年起汇编的数据库)。组间比较采用Wilcoxon检验(定量数据)或Fisher精确检验(定性数据)。
我们发现IUGR组子痫前期出现得更早且更严重。此外,当IUGR与子痫前期相关时,胎儿情况更不利。
IUGR与子痫前期或HELLP综合征并存是母婴严重程度的一个标准。我们的数据无法区分解释这些差异的病理生理机制。