Ebbing Cathrine, Rasmussen Svein, Skjaerven Rolv, Irgens Lorentz M
Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway.
Department of Clinical Science, University of Bergen, Bergen, Norway.
Acta Obstet Gynecol Scand. 2017 Feb;96(2):243-250. doi: 10.1111/aogs.13066. Epub 2017 Jan 6.
Hypertensive disorders of pregnancy (HDP) tend to recur from one pregnancy to the next. The aims of the study were to assess the recurrence risk according to type of HDP defined by gestational age at birth and to examine whether recurrence is associated with the following additional risk factors for HDP: maternal age, smoking, inter-delivery interval, diabetes, body mass index, and fetal growth restriction, and to assess temporal trends in these associations.
All women with two singleton births in the Medical Birth Registry of Norway 1967-2012 (n = 742 980) were included in this population-based cohort study. Logistic regression was used to calculate odds ratios for the risk of recurrent HDP according to type of HDP.
The highest odds ratio of recurrence was observed for the same type of HDP based on gestational age at delivery. After gestational hypertension and term preeclampsia, the risk for the same type to recur increased 10-fold, whereas after late and early preterm preeclampsia, the risk increased 27- and 97-fold, respectively. The recurrence of early preterm preeclampsia was less influenced by additional risk factors compared with term HDP. Recurrence of early preterm HDP was significantly lower from 1993 onwards.
Recurrent HDP tended to be of the same type as the previous HDP. Risk of recurrence associated with additional risk factors was observed particularly after term. The odds ratio of recurrence of early preterm HDP was significantly lower from 1993 onwards.
妊娠高血压疾病（HDP）往往会在不同次妊娠中复发。本研究的目的是根据出生时的孕周所定义的HDP类型评估复发风险，并检查复发是否与以下HDP的额外风险因素相关：产妇年龄、吸烟、分娩间隔、糖尿病、体重指数和胎儿生长受限，并评估这些关联的时间趋势。
在挪威医疗出生登记处1967 - 2012年有两次单胎分娩的所有女性（n = 742980）纳入了这项基于人群的队列研究。采用逻辑回归根据HDP类型计算复发性HDP风险的比值比。
基于分娩时的孕周，观察到相同类型的HDP复发比值比最高。妊娠高血压和足月子痫前期之后，同一类型复发的风险增加10倍，而晚期和早期早产子痫前期之后，风险分别增加27倍和97倍。与足月HDP相比，早期早产子痫前期的复发受额外风险因素的影响较小。从1993年起，早期早产HDP的复发率显著降低。
复发性HDP往往与之前的HDP类型相同。特别是在足月后观察到与额外风险因素相关的复发风险。从1993年起，早期早产HDP的复发比值比显著降低。
