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早产对产妇远期心脑血管事件的影响

[Impact of premature birth on long term cardio-cerebral vascular events of puerpera].

作者信息

Li Dongqing, Tao Jie, Dong Yan, Zhao Haiyan, Gao Xinying, Ji Chunpeng, Wang Lijiao, Xiang Honghu, Wu Shouling

机构信息

Department of Cardiology, Affiliated Kailuan Hospital, Hebei United University, Tangshan 063000, China.

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出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Jul;42(7):598-602.

Abstract

OBJECTIVE

To investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera.

METHODS

Ambispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth (PTB) group (n = 226) and non-PTB (NPTB) group (n = 3 433) by the history of PTB. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.

RESULTS

(1) The childbearing age, proportion of pregnancy-induced hypertension, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group (P < 0.05 or 0.01). (2) There were 71 cardio-cerebral vascular events during the follow-up of (15.19 ± 7.75) years. In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group (all P < 0.05). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold (95% CI: 1.02-4.04, P = 0.002) and 3.11 fold (95% CI: 1.18-8.18, P < 0.001) higher than in NPTB group.

CONCLUSION

PTB is an independent risk factor for total cardio-cerebral vascular events, especially myocardial infarction of puerpera.

摘要

目的

探讨早产对产妇远期心脑血管事件的影响。

方法

采用双向队列研究方法,纳入1976年10月至2008年12月在开滦医疗集团分娩的3659例孕妇,根据早产史分为早产(PTB)组(n = 226)和非早产(NPTB)组(n = 3433)。随访期间获取心脑血管事件(心肌梗死、脑梗死和脑出血)的发生率。采用多变量Cox比例风险回归模型评估心脑血管事件的相对风险。

结果

(1)PTB组产妇的生育年龄、妊娠期高血压比例、分娩前收缩压和舒张压显著高于NPTB组,而新生儿体重和身高显著低于NPTB组(P < 0.05或0.01)。(2)在(15.19 ± 7.75)年的随访期间,共发生71例心脑血管事件。PTB组心脑血管事件和心肌梗死的发生率分别为3.23/1000人年和2.05/1000人年,而NPTB组相应发生率分别为1.15/1000人年和0.42/1000人年(均P < 0.05)。在调整其他传统心血管危险因素后,PTB组总心脑血管事件、心肌梗死的风险分别比NPTB组高2.03倍(95%CI:1.02 - 4.04,P = 0.002)和3.11倍(95%CI:1.18 - 8.18,P < 0.001)。

结论

早产是产妇发生总心脑血管事件尤其是心肌梗死的独立危险因素。

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