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子痫前期家族史和心血管疾病作为子痫前期的危险因素:GenPE病例对照研究

Family history of pre-eclampsia and cardiovascular disease as risk factors for pre-eclampsia: the GenPE case-control study.

作者信息

Serrano Norma C, Quintero-Lesmes Doris Cristina, Dudbridge Frank, Leon Lydia J, Hingorani Aroon D, Williams David J, Casas Juan P

机构信息

Fundación Cardiovascular de Colombia FCV.

Universidad Autónoma de Bucaramanga, Colombia.

出版信息

Hypertens Pregnancy. 2020 Feb;39(1):56-63. doi: 10.1080/10641955.2019.1704003. Epub 2020 Jan 7.

DOI:10.1080/10641955.2019.1704003
PMID:31910697
Abstract

: To determine whether family history of pre-eclampsia and cardiovascular disease is consistently associated with the occurrence of pre-eclampsia sub-phenotypes and fetal growth restriction (FGR).: We conducted a case-control study in which cases of pre-eclampsia and healthy pregnant controls were recruited at the time of delivery from eight Colombian cities between 2000 and 2012. Odds of pre-eclampsia among women with a positive family history of pre-eclampsia or cardiovascular disease were compared to women without affected relatives (logistic regression modeling and multinomial logistic regression model [Ajusted]).: A total of 3510 pre-eclampsia cases and 4512 controls with data on family history of pre-eclampsia were included in analyses. A subsample of 3086 cases and 3888 controls also provided information on family history of cardiovascular disease. Women whose mothers had pre-eclampsia had 3.38 (95% CI 2.89, 3.96) higher odds than those who did not, and having an affected sister increased pre-eclampsia odds by 2.43 (95% CI 2.02, 2.93). The effect of having both mother and sister affected with pre-eclampsia was stronger than the two independent risk factors (OR 4.17 [95% CI 2.60, 6.69]). Women with parental history of cardiovascular disease also had an increased risk of pre-eclampsia (OR 1.58 [95% CI 1.24, 2.01]).: Family history of pre-eclampsia increased the risk of PE. The impact of family history of cardiovascular disease on pre-eclampsia was more conservative, but serves to support the hypothesis that pre-eclampsia may reflect the premature exposure of underlying cardiovascular dysfunction, precipitated by the stress test of pregnancy.

摘要

目的

确定子痫前期和心血管疾病家族史是否始终与子痫前期亚表型的发生及胎儿生长受限(FGR)相关。

方法

我们进行了一项病例对照研究,于2000年至2012年间在哥伦比亚的八个城市分娩时招募子痫前期病例和健康孕妇作为对照。将有子痫前期或心血管疾病家族史阳性的女性患子痫前期的几率与无患病亲属的女性进行比较(逻辑回归建模和多项逻辑回归模型[校正后])。

结果

分析纳入了3510例有子痫前期家族史数据的子痫前期病例和4512例对照。3086例病例和3888例对照的子样本还提供了心血管疾病家族史信息。母亲患有子痫前期的女性患子痫前期的几率比未患病者高3.38倍(95%CI 2.89, 3.96),有患病姐妹使子痫前期几率增加2.43倍(95%CI 2.02, 2.93)。母亲和姐妹均患子痫前期的影响比两个独立危险因素更强(OR 4.17 [95%CI 2.60, 6.69])。有心血管疾病家族史的女性患子痫前期的风险也增加(OR 1.58 [95%CI 1.24, 2.01])。

结论

子痫前期家族史增加了患子痫前期的风险。心血管疾病家族史对子痫前期的影响较为保守,但支持了子痫前期可能反映潜在心血管功能障碍过早暴露的假说,这种暴露是由妊娠应激试验引发的。

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