Sekkarie Ahlia, Raskind-Hood Cheryl, Hogue Carol
a Department of Epidemiology, Rollins School of Public Health , Emory University , Atlanta , GA , USA.
J Matern Fetal Neonatal Med. 2016;29(4):602-6. doi: 10.3109/14767058.2015.1012064. Epub 2015 Feb 24.
Patient data from Maison de Naissance (MN), a rural maternity clinic in Haiti, were analyzed to determine the prevalence of pregnancy-related hypertensive disorders and the extent to which maternal weight and age are associated with these disorders in the MN population.
A case-control study design was used with cases defined as pregnant women who were presented at MN with pregnancy-related hypertensive disorders (pregnancy-induced hypertension, pre-eclampsia or eclampsia) and controls defined as those women who delivered babies at MN and were not diagnosed with a pregnancy-related hypertensive disorder. The final cohort size was 622 controls and 67 cases. Odds ratios were calculated using multivariate logistic regression.
The incidence of pre-eclampsia and eclampsia was 7.0%. Older maternal age at delivery (OR = 3.18; 95%CI: 1.31, 7.76) and higher maternal weight (OR = 3.24; 95%CI: 1.76, 5.98) measured during prenatal care were significantly associated with pregnancy-related hypertensive disorders. Prenatal care was not significantly associated with reduced risk of pre-eclampsia/eclampsia.
The prevalence of pregnancy-related hypertensive disorders was high relative to rates in other developing countries. More is required to reduce the rate of pre-eclampsia perhaps by targeting older and women with high weight for preconception and more intensive prenatal care.
对海地一家农村产科诊所——“出生之家”(MN)的患者数据进行分析,以确定妊娠相关高血压疾病的患病率,以及在MN人群中孕产妇体重和年龄与这些疾病的关联程度。
采用病例对照研究设计,病例定义为在MN就诊的患有妊娠相关高血压疾病(妊娠高血压、先兆子痫或子痫)的孕妇,对照定义为在MN分娩且未被诊断患有妊娠相关高血压疾病的女性。最终队列规模为622名对照和67例病例。使用多因素逻辑回归计算比值比。
先兆子痫和子痫的发病率为7.0%。产前检查时测量的较高产妇年龄(比值比=3.18;95%置信区间:1.31,7.76)和较高产妇体重(比值比=3.24;95%置信区间:1.76,5.98)与妊娠相关高血压疾病显著相关。产前检查与降低先兆子痫/子痫风险无显著关联。
相对于其他发展中国家的发病率,妊娠相关高血压疾病的患病率较高。或许需要采取更多措施来降低先兆子痫的发生率,可能要针对年龄较大和体重较高的女性进行孕前干预,并提供更强化的产前护理。