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妊娠高血压疾病与不良妊娠结局风险:2368 例患者的回顾性队列研究。

Hypertensive disorders of pregnancy and risks of adverse pregnancy outcomes: a retrospective cohort study of 2368 patients.

机构信息

Department of Obstetrics, Xiangya Hospital of Central South University, 87 Xiangya Road, Changsha, 410008, China.

Hunan Engineering Research Center of Early Life Development and Disease Prevention, 87 Xiangya Road, Changsha, 410008, China.

出版信息

J Hum Hypertens. 2021 Jan;35(1):65-73. doi: 10.1038/s41371-020-0312-x. Epub 2020 Feb 17.

Abstract

Hypertensive disorders of pregnancy (HDP) comprise a group of hypertension-related diseases and represent the most common medical disorders in pregnancy. The aim of this study was to investigate the risks of adverse pregnancy outcomes in patients with different types of HDP, including gestational hypertension, chronic hypertension, preeclampsia (PE, early or late onset), PE superimposed on chronic hypertension (superimposed PE), eclampsia, and HELLP syndrome. Data from a multicenter retrospective patient cohort in China were analyzed. Seventeen adverse maternal or perinatal outcomes were evaluated. Logistic regression was used to estimate the risk of adverse outcomes for each HDP subgroups, using the gestational hypertension group as the reference. The final analysis included 2368 patients with HDP. Of these, 39.9% of patients reported at least one adverse pregnancy outcome. Patients with early onset PE had the highest risk for having both adverse maternal and perinatal outcomes (OR = 7.28, 95% CI: 2.68, 19.79). The risk of perinatal death significantly increased in HELLP syndrome, superimposed PE, and early onset PE, (OR = 13.81, 6.32, and 4.84, respectively, p < 0.05) groups. This study highlights that among patients with HDP, those with early onset PE had the highest risk for having both adverse maternal and perinatal outcomes, and patients with HELLP syndrome had the highest risk for perinatal death.

摘要

妊娠高血压疾病(HDP)包括一组与高血压相关的疾病,是妊娠中最常见的医学疾病。本研究旨在探讨不同类型 HDP(妊娠期高血压、慢性高血压、子痫前期(PE,早发型或晚发型)、PE 合并慢性高血压(重叠性 PE)、子痫和 HELLP 综合征)患者不良妊娠结局的风险。对中国多中心回顾性患者队列的数据进行了分析。评估了 17 种不良母婴结局。使用逻辑回归,以妊娠期高血压组为参照,估计每个 HDP 亚组不良结局的风险。最终分析包括 2368 例 HDP 患者。其中,39.9%的患者报告至少有一种不良妊娠结局。早发型 PE 患者发生不良母婴结局的风险最高(OR=7.28,95%CI:2.68,19.79)。HELLP 综合征、重叠性 PE 和早发型 PE 患者的围产儿死亡风险显著增加(OR=13.81、6.32 和 4.84,p<0.05)。本研究表明,在 HDP 患者中,早发型 PE 患者发生不良母婴结局的风险最高,HELLP 综合征患者发生围产儿死亡的风险最高。

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