Institute of Disaster Medicine, Tianjin University, Tianjin, China.
Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury, Pingjin Hospital Heart Centre, Tianjin, China.
J Matern Fetal Neonatal Med. 2020 Apr;33(8):1447-1454. doi: 10.1080/14767058.2018.1519015. Epub 2018 Sep 25.
Emerging evidence shows that high blood pressure (BP) level even below 140/90 mmHg during pregnancy is associated with increased risk for maternal and infant complications. The meta-analysis evaluated the associations between prehypertension (BP 120-139/80-89 mmHg) during pregnancy and the risk of small for gestational age (SGA), as well as the impact of prehypertension on birth weight (BW). Databases (PubMed, Embase, and Cochrane Library) were searched for cohort studies with data on prehypertension in pregnancy and adverse obstetrical outcomes, including SGA and/or BW. The relative risks (RRs) of SGA and weighted mean differences (WMD) in BW were calculated and reported with 95% confidence intervals (95% CIs). We calculated pooled RRs using fixed- and random-effects models. A total of 143,835 participants from five cohort studies were included. Prehypertension in pregnancy increased the risk of SGA (RR 1.59, 95%CI 1.44 to 1.76, < .00001) and lowered BW (WMD -13.71, 95% CI -83.28 to 55.87, = .70) compared with optimal BP (<120/80 mmHg). In subgroup analyses, for prehypertension in late pregnancy, the risk of SGA was significantly higher than for optimal BP (RR 1.60, 95% CI 1.44 to 1.78). BP within the range of 120-139/80-89 mmHg during pregnancy, as previously defined as prehypertension, particularly in late pregnancy, was associated with a 59% increase in the risk of having an SGA birth.
新出现的证据表明，即使在怀孕期间血压水平低于 140/90mmHg，也与母婴并发症风险增加有关。这项荟萃分析评估了怀孕期间的高血压前期（血压 120-139/80-89mmHg）与胎儿生长受限（SGA）风险之间的关系，以及高血压前期对出生体重（BW）的影响。使用了数据库（PubMed、Embase 和 Cochrane Library），搜索了有关怀孕期间高血压前期与不良产科结局（包括 SGA 和/或 BW）的队列研究数据。计算了 SGA 和 BW 的加权均数差异（WMD）的相对风险（RR），并报告了 95%置信区间（95%CI）。我们使用固定效应和随机效应模型计算了汇总 RR。共有来自五项队列研究的 143835 名参与者被纳入研究。与最佳血压（<120/80mmHg）相比，怀孕期间的高血压前期增加了 SGA（RR 1.59，95%CI 1.44-1.76， < .00001）和降低 BW（WMD-13.71，95%CI-83.28-55.87， = .70）的风险。在亚组分析中，对于晚期妊娠的高血压前期，SGA 的风险明显高于最佳血压（RR 1.60，95%CI 1.44-1.78）。怀孕期间血压在 120-139/80-89mmHg 范围内，如前所述，作为高血压前期，特别是在晚期妊娠，与 SGA 出生的风险增加 59%相关。
