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比较早孕期子痫前期筛查时和产前检查时获得的早孕期血压。

A comparison of first trimester blood pressures obtained at the time of first trimester pre-eclampsia screening and those obtained during prenatal care visits.

机构信息

Department of Health Sciences, Division of Obstetrics and Gynecology, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.

Center for Fetal Therapy, Department of Gynecology and Obstetrics, Johns Hopkins Hospital, Baltimore, MD, USA.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2020 May;248:77-80. doi: 10.1016/j.ejogrb.2020.03.018. Epub 2020 Mar 7.

Abstract

OBJECTIVE

To determine if enrollment blood pressures in a study on first trimester preeclampsia prediction significantly differed from those obtained during routine prenatal care visits in the first trimester.

STUDY DESIGN

Women carrying a singleton gestation were prospectively enrolled in a first trimester study on preeclampsia prediction, and had systolic and diastolic blood pressure (SBP, DBP) measured at the time of enrollment. Blood pressure was also measured with the same technique by clinic nurses during the routine prenatal visits throughout the first trimester of pregnancy (9-14 weeks). The enrollment-BP (E-BP) and average first trimester-BP (aFT-BP) were compared using a paired samples t-test or Wilcoxon test, as appropriate. Smokers and patients on antihypertensive medications were excluded from the analysis. test.

RESULTS

644 women had prenatal care in the primary study center and met study criteria. The mean gestational age at study enrollment was 12.5 weeks. No significant difference was found between E-SBP and aFT-SBP (p = 0.10). Enrollment DBP and mean arterial pressure (MAP) were significantly lower than the aFT- DBP and -MAP (median DPB 67 vs 70 mm Hg and median MAP 83.7 vs 85 mmHg, respectively, p < 0.001). However, the difference was not clinically relevant (3 mmHg for DBP, and 1.3 mmHg for MAP).

CONCLUSIONS

Blood pressures obtained in a setting of preeclampsia screening are not higher than those obtained during regular prenatal care in the first trimester. This suggests that the setting in which pre-eclampsia screening is performed is unlikely to be a confounder for blood pressure measurements and the risk assessment.

摘要

目的

确定在一项关于早孕期子痫前期预测的研究中,入组血压是否显著不同于在早孕期常规产前检查中获得的血压。

研究设计

前瞻性地招募了携带单胎妊娠的女性参加早孕期子痫前期预测研究,并在入组时测量收缩压(SBP)和舒张压(DBP)。在整个孕早期(9-14 周),诊所护士也使用相同的技术在常规产前检查中测量血压。使用配对样本 t 检验或 Wilcoxon 检验比较入组血压(E-BP)和平均早孕期血压(aFT-BP),具体取决于数据类型。排除吸烟和服用降压药物的患者进行分析。

结果

644 名女性在主要研究中心接受产前护理并符合研究标准。研究入组时的平均妊娠龄为 12.5 周。E-SBP 与 aFT-SBP 之间无显著差异(p=0.10)。E-DBP 和平均动脉压(MAP)明显低于 aFT-DBP 和 -MAP(中位数 DBP 为 67 与 70mmHg,中位数 MAP 为 83.7 与 85mmHg,分别为,p<0.001)。然而,差异无临床意义(DBP 为 3mmHg,MAP 为 1.3mmHg)。

结论

子痫前期筛查时获得的血压并不高于早孕期常规产前护理时获得的血压。这表明子痫前期筛查的环境不太可能是血压测量和风险评估的混杂因素。

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