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夫妻因素对妊娠期高血压疾病的影响:一项回顾性队列研究。

Influence of the couple on hypertensive disorders during pregnancy: A retrospective cohort study.

作者信息

Bertozzi Serena, Londero Ambrogio P, Salvador Stefania, Grassi Tiziana, Fruscalzo Arrigo, Driul Lorenza, Marchesoni Diego

机构信息

Department of Surgery, AOU "SM della Misericordia" of Udine, 33100 Udine, Italy.

Clinic of Obstetrics and Gynecology, AOU "SM della Misericordia" of Udine, 33100 Udine, Italy.

出版信息

Pregnancy Hypertens. 2011 Apr;1(2):156-63. doi: 10.1016/j.preghy.2011.01.005. Epub 2011 Feb 18.

Abstract

OBJECTIVE

Our study investigates a possible couple predisposition for pregnancy-related hypertensive disorders (PRHDs).

MATERIALS AND METHODS

We selected 350 women with PRHDs and a random control cohort without PRHDs. We analyzed their clinical files and asked them and their partners about clinical information and family history for some common pathologies. Statistical bivariate and multivariate analysis was performed by R, considering significant p<0.05.

RESULTS

Familial history reveals in cases more maternal grandparents hypertension and thrombophilia, and paternal, personal and familial, thrombophilia history than in controls. By multivariate analysis, the occurrence of PRHDs is influenced by stress, maternal BMI, maternal chronic hypertension, pre-pregnancy diabetes mellitus, nulliparity, maternal grandmother and grandfather hypertension; and academic degrees is a protective factor. Selecting only multipara, PRHDs correlate with advanced maternal age, higher maternal BMI, chronic hypertension, longer interpregnancy interval, stress, previous pregnancies affected by PRHDs, and paternal, personal and familial, thrombophilia history. Moreover the multivariate logistic regression models considering parents familial and personal history results are accurate to predict PRHDs with an AUC of 79% in the general population and 82% among multiparous women.

CONCLUSIONS

The couple should be evaluated together for PRHDs risk, both parents familial history should be considered in PRHDs screening programs, and further studies are required, in a society continuously changing its characteristics and habits.

摘要

目的

我们的研究调查了妊娠相关高血压疾病(PRHDs)可能存在的夫妇易感性。

材料与方法

我们选取了350例患有PRHDs的女性以及一个无PRHDs的随机对照队列。我们分析了她们的临床档案,并询问她们及其伴侣一些常见病症的临床信息和家族史。使用R软件进行双变量和多变量统计分析,以p<0.05为有统计学意义。

结果

家族史显示,与对照组相比,病例组中更多孕妇的祖父母患有高血压和血栓形成倾向,以及父亲、个人和家族的血栓形成倾向病史。通过多变量分析,PRHDs的发生受压力、孕妇体重指数(BMI)、孕妇慢性高血压、孕前糖尿病、未生育、孕妇祖父母高血压的影响;而学历是一个保护因素。仅选择经产妇,PRHDs与孕妇高龄、较高的孕妇BMI、慢性高血压、较长的妊娠间隔、压力、既往受PRHDs影响的妊娠以及父亲、个人和家族的血栓形成倾向病史相关。此外,考虑父母家族史和个人史结果的多变量逻辑回归模型在预测PRHDs方面具有较高准确性,在普通人群中的曲线下面积(AUC)为79%,在经产妇中为82%。

结论

应共同评估夫妇双方患PRHDs的风险,在PRHDs筛查项目中应考虑父母双方的家族史,并且在一个社会特征和习惯不断变化的情况下,还需要进一步研究。

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