Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion, BP 350, 97448 Saint Pierre Cedex, France; Centre d'Etudes Périnatales de l'Océan Indien (EA 7388), CHU La Réunion, BP 350, Saint Pierre Cedex,97448, France.
Réanimation Néonatale et Pédiatrique, Néonatologie, CHU La Réunion, BP 350, 97448 Saint Pierre Cedex, France; Centre d'Etudes Périnatales de l'Océan Indien (EA 7388), CHU La Réunion, BP 350, Saint Pierre Cedex,97448, France.
J Reprod Immunol. 2017 Sep;123:12-16. doi: 10.1016/j.jri.2017.08.005. Epub 2017 Aug 24.
Clinical differences, maternal risk factors and pregnancy outcomes of deliveries complicated by early- (delivery<34 weeks) and late-onset (delivery≥34 weeks) preeclampsia were studied in a cohort of women in Reunion Island during 15 years (period 2001-2015; N=62,230 pregnancies). The overall preeclampsia rate in singleton pregnancies was 2.37%. Early- and late-onset preeclampsia rates were 0.75% and 1.5% respectively, and the trend for each type of disease was stable over time. In both form of preeclampsia, smoking during pregnancy was a protective factor and associated risk factors were: older age, primiparity, pre-existing diabetes, chronic hypertension, higher pre-pregnancy body mass index and obesity, infertility treatment, history of renal disease and hypercholesterolemia (all p<0.05). The rate of caesarean section, medically-induced delivery and impaired foetal and neonatal outcomes were significantly higher in preeclamptic women (all p<0.0001). When comparing early- versus late-onset preeclampsia, the only difference was the older maternal age in primiparae with early-onset preeclampsia (p=0.02), and the two groups of preeclamptic women were similar in terms of maternal risk factors, with the exception of higher rates of chronic hypertension in early-onset preeclampsia (p=0.02). Foetal and neonatal outcomes were evaluated after adjustment for gestational age at delivery and no difference was detected between early- and late-onset preeclamptic women. These analyses failed to identify a specific phenotype of preeclampsia in terms of predisposition or pre-existing risk factors for one form or another. Gestational age at delivery was the most important predictor for offspring outcome.
在留尼汪岛的一项队列研究中，对 15 年来（2001-2015 年）的产妇临床资料进行了分析，比较了早发型（<34 周）和晚发型（≥34 周）子痫前期的产妇特征、危险因素和妊娠结局。单胎妊娠的子痫前期总发生率为 2.37%。早发型和晚发型子痫前期的发生率分别为 0.75%和 1.5%，且每种疾病的趋势在时间上均保持稳定。在这两种形式的子痫前期中，孕期吸烟均为保护因素，且相关的危险因素为：年龄较大、初产妇、孕前糖尿病、慢性高血压、孕前体质量指数和肥胖较高、不孕治疗、肾病和高胆固醇血症病史（均 P<0.05）。子痫前期产妇剖宫产、医源性分娩和胎儿及新生儿结局受损的发生率明显更高（均 P<0.0001）。比较早发型和晚发型子痫前期，初产妇中仅早发型子痫前期的产妇年龄较大（P=0.02），且两组子痫前期产妇的危险因素相似，除早发型子痫前期的慢性高血压发生率较高（P=0.02）外。对分娩时的胎龄进行调整后评估胎儿和新生儿结局，未发现早发型和晚发型子痫前期产妇之间存在差异。这些分析未能确定一种特殊的子痫前期表型，即易患性或另一种形式的潜在危险因素。分娩时的胎龄是预测后代结局的最重要因素。
