Department of Obstetrics and Gynecology, University of Campinas, Campinas, Brazil.
Int J Gynaecol Obstet. 2020 May;149(2):148-153. doi: 10.1002/ijgo.13114. Epub 2020 Mar 4.
To describe maternal and perinatal outcomes for women with chronic hypertension, comparing those with superimposed pre-eclampsia (SPE) with those without pre-eclampsia (NPE).
In a retrospective cohort study in a tertiary hospital in Brazil, the records of women with chronic hypertension were reviewed between January 1, 2012, and May 31, 2017, in order to compare maternal and perinatal outcomes among those with and without SPE. Poisson regression was performed to investigate factors independently associated with severe pre-eclampsia.
Of 385 women with chronic hypertension included in the study, 167 were in the SPE group and 218 in the NPE group. The majority were white, overweight (body mass index ≥30 kg/m ), with mean age around 31 years. Adverse neonatal outcomes were significantly more prevalent among women with SPE, including small for gestational age (SPE 17.46% vs NPE 9.63%, P=0.01), low birth weight (SPE 2577 g ± 938 vs NPE 3128 g ± 723, P=0.003), neonatal intensive care unit admission (SPE 44.91% vs NPE 18.34%, P=0.08), and incidence of cesarean delivery (SPE 79.64% vs NPE 62.38%, P=0.003). Fetal growth restriction (PR [prevalence ratio] 2.62, 95% confidence interval [CI] 1.39-4.94) and previous pre-eclampsia (PR 1.96, 95% CI 1.17-3.28) were associated with severe pre-eclampsia.
SPE is associated with prematurity and higher rates of admission to neonatal intensive care unit. Fetal growth restriction and previous pre-eclampsia are factors associated with severe complications of pre-eclampsia.
描述患有慢性高血压的产妇和围产儿结局，比较合并与不合并先兆子痫（SPE）的患者。
本研究为巴西一家三级医院的回顾性队列研究，对 2012 年 1 月 1 日至 2017 年 5 月 31 日期间患有慢性高血压的女性病历进行了回顾，以比较合并与不合并 SPE 的产妇和围产儿结局。采用泊松回归分析探讨与重度子痫前期相关的独立因素。
研究共纳入 385 例慢性高血压女性患者，其中 167 例为 SPE 组，218 例为 NPE 组。大多数患者为白人，超重（体重指数≥30kg/m²），平均年龄约为 31 岁。SPE 组的不良新生儿结局明显更为常见，包括小于胎龄儿（SPE 17.46% vs NPE 9.63%，P=0.01）、低出生体重儿（SPE 2577g±938 vs NPE 3128g±723，P=0.003）、新生儿重症监护病房收治率（SPE 44.91% vs NPE 18.34%，P=0.08）和剖宫产率（SPE 79.64% vs NPE 62.38%，P=0.003）。胎儿生长受限（PR [患病率比] 2.62，95%置信区间 [CI] 1.39-4.94）和既往子痫前期（PR 1.96，95% CI 1.17-3.28）与重度子痫前期相关。
SPE 与早产和新生儿重症监护病房收治率较高有关。胎儿生长受限和既往子痫前期是与子痫前期严重并发症相关的因素。
