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孕前因素与子痫前期妇女后期高血压的发生有关。

Prepregnancy Factors Are Associated with Development of Hypertension Later in Life in Women with Pre-Eclampsia.

机构信息

1Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Republic of Korea.

2Big Data Steering Department, National Health Insurance Service, Wonju, Republic of Korea.

出版信息

J Womens Health (Larchmt). 2019 Jul;28(7):984-989. doi: 10.1089/jwh.2018.7165. Epub 2018 Oct 3.

Abstract

The aim of our study was to investigate the prepregnancy characteristics that are risk factors for the development of hypertension (HTN) and identify prepregnancy factors for the development of HTN in women affected by pre-eclampsia in their first pregnancy. We enrolled 1910 women who had undergone a National Health Screening Examination through the National Health Insurance Corporation between 2002 and 2003, and who had their first delivery affected by pre-eclampsia in 2004. Women were classified as having HTN if they were newly diagnosed with HTN from 2005 through 2012. After 8 years of follow-up, 7.7% (148/1910) of pre-eclamptic women developed HTN. Using the Cox proportional hazards model, old age (hazard ratio [HR] 3.92, 95% confidence interval [CI] 2.47-6.23), a family history of HTN (HR 2.28, 95% CI 1.46-3.58), prepregnancy obesity (HR 3.74, 95% CI 2.50-5.59), and high blood pressure (BP) (HR 2.78, 95% CI 1.85-4.19) were independently associated with the development of HTN. The results show that the development of HTN in pre-eclamptic women is related to prepregnancy factors. Recognizing who subsequently develops HTN postpartum in pre-eclamptic women with these prepregnancy factors could lead to early identification and lifestyle interventions, which could reduce the burden of cardiovascular disease.

摘要

我们的研究目的是调查可能导致高血压(HTN)发生的孕前特征,并确定首次妊娠子痫前期患者发生 HTN 的孕前因素。我们纳入了 1910 名女性,她们于 2002 年至 2003 年期间通过国家健康保险公司进行了国家健康筛查检查,并且于 2004 年首次分娩时患有子痫前期。如果这些女性在 2005 年至 2012 年期间被新诊断为 HTN,则被归类为患有 HTN。经过 8 年的随访,1910 名子痫前期患者中有 7.7%(148/1910)发展为 HTN。使用 Cox 比例风险模型,高龄(风险比 [HR] 3.92,95%置信区间 [CI] 2.47-6.23)、HTN 家族史(HR 2.28,95% CI 1.46-3.58)、孕前肥胖(HR 3.74,95% CI 2.50-5.59)和高血压(BP)(HR 2.78,95% CI 1.85-4.19)与 HTN 的发生独立相关。结果表明,子痫前期患者 HTN 的发生与孕前因素有关。识别出这些孕前因素的子痫前期患者中哪些人随后会在产后发生 HTN,可以进行早期识别和生活方式干预,从而降低心血管疾病的负担。

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