Nuffield Department of Clinical Neurosciences, Nuffield Department of Women's & Reproductive Health, the Department of Engineering Science, and the Centre for Statistics in Medicine, University of Oxford, Oxford, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, Guy's and St Thomas' NHS Foundation Trust, London, the Department of Women and Children's Health, King's College, London, and the Oxford National Institute for Health Research Biomedical Research Centre, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
Obstet Gynecol. 2020 Mar;135(3):653-664. doi: 10.1097/AOG.0000000000003721.
To estimate normal ranges for maternal vital signs throughout pregnancy, which have not been well defined in a large contemporary population.
We conducted a three-center, prospective, longitudinal cohort study in the United Kingdom from August 2012 to September 2017. We recruited women at less than 20 weeks of gestation without significant comorbidities with accurately dated singleton pregnancies. We measured participants' blood pressure (BP), heart rate, respiratory rate, oxygen saturation and temperature following standardized operating procedures at 4-6 weekly intervals throughout pregnancy.
We screened 4,279 pregnant women, 1,041 met eligibility criteria and chose to take part. Systolic and diastolic BP decreased slightly from 12 weeks of gestation: median or 50th centile (3rd-97th centile) 114 (95-138); 70 (56-87) mm Hg to reach minimums of 113 (95-136); 69 (55-86) mm Hg at 18.6 and 19.2 weeks of gestation, respectively, a change (95% CI) of -1.0 (-2 to 0); -1 (-2 to -1) mm Hg. Systolic and diastolic BP then rose to a maximum median (3rd-97th centile) of 121 (102-144); 78 (62-95) mm Hg at 40 weeks of gestation, a difference (95% CI) of 7 (6-9) and9 (8-10) mm Hg, respectively. The median (3rd-97th centile) heart rate was lowest at 12 weeks of gestation: 82 (63-105) beats per minute (bpm), rising progressively to a maximum of 91 (68-115) bpm at 34.1 weeks. SpO2 decreased from 12 weeks of gestation: median (3-97 centile) 98% (94-99%) to 97% (93-99%) at 40 weeks. The median (3-97 centile) respiratory rate at 12 weeks of gestation was 15 (9-22), which did not change with gestation. The median (3-97 centile) temperature at 12 weeks of gestation was 36.7 (35.6-37.5)°C, decreasing to a minimum of 36.5 (35.3-37.3)°C at 33.4 weeks.
We present widely relevant, gestation-specific reference ranges for detecting abnormal BP, heart rate, respiratory rate, oxygen saturation and temperature during pregnancy. Our findings refute the existence of a clinically significant BP drop from 12 weeks of gestation.
ISRCTN, ISRCTN10838017.
评估整个孕期母体生命体征的正常范围，在当代大样本人群中，这些范围尚未得到很好的定义。
我们在英国进行了一项三中心、前瞻性、纵向队列研究，时间为 2012 年 8 月至 2017 年 9 月。我们招募了不到 20 周妊娠且无明显合并症的单胎孕妇，并按照标准化操作程序，在整个孕期每 4-6 周间隔测量参与者的血压（BP）、心率、呼吸频率、血氧饱和度和体温。
我们筛查了 4279 名孕妇，有 1041 名符合入选标准并选择参与。从 12 周妊娠开始，收缩压和舒张压略有下降：中位数或 50 百分位（3 至 97 百分位）分别为 114（95-138）；70（56-87）mmHg，分别达到 18.6 和 19.2 周妊娠时的最低值 113（95-136）；69（55-86）mmHg，变化（95%CI）为-1.0（-2 至 0）；-1（-2 至-1）mmHg。收缩压和舒张压随后上升至 40 周妊娠时的最高中位数（3 至 97 百分位）121（102-144）；78（62-95）mmHg，差值（95%CI）分别为 7（6-9）和 9（8-10）mmHg。心率的中位数（3 至 97 百分位）在 12 周妊娠时最低：82（63-105）次/分钟（bpm），逐渐上升至 34.1 周时的最高值 91（68-115）bpm。SpO2 从 12 周妊娠开始下降：中位数（3-97 百分位）98%（94-99%）降至 40 周妊娠时的 97%（93-99%）。12 周妊娠时的呼吸频率中位数（3-97 百分位）为 15（9-22），与妊娠无关。12 周妊娠时的体温中位数（3-97 百分位）为 36.7（35.6-37.5）°C，降至 33.4 周时的最低值 36.5（35.3-37.3）°C。
我们提出了广泛相关的、妊娠特异性的参考范围，用于检测整个孕期的异常血压、心率、呼吸频率、血氧饱和度和体温。我们的研究结果反驳了从 12 周妊娠开始存在临床显著血压下降的观点。
ISRCTN，ISRCTN10838017。
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