高海拔居住会改变血压变化过程，并增加妊娠高血压疾病。
High-altitude residence alters blood-pressure course and increases hypertensive disorders of pregnancy.
机构信息
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado Denver - Anschutz Medical Campus, Aurora, CO, USA.
Center for Health and Environmental Data, Colorado Department of Public Health and Environment, Denver, CO, USA.
出版信息
J Matern Fetal Neonatal Med. 2022 Apr;35(7):1264-1271. doi: 10.1080/14767058.2020.1745181. Epub 2020 Mar 30.
OBJECTIVES
To determine whether the full spectrum of hypertensive disorders of pregnancy (HDP) - comprising gestational hypertension; preeclampsia with or without severe features; eclampsia; and emolysis, levated iver enzymes, and ow latelets (HELLP) Syndrome - is increased at high (≥2500 m, 8250 ft) compared with lower altitudes in Colorado independent of maternal background characteristics, and if so their relationship to neonatal well-being.
METHODS
A retrospective cohort study was conducted using statewide birth-certificate data to compare the frequency of gestational hypertension, preeclampsia (with or without severe features), eclampsia, HELLP Syndrome, or all HDP combined in 617,958 Colorado women who lived at high vs. low altitude (<2500 m) and delivered during the 10-year period, 2007-2016. We also compared blood-pressure changes longitudinally during pregnancy and the frequency of HDP in 454 high (>2500 m)- vs. low (<1700 m)-altitude Colorado residents delivering in 2013 and 2014, and matched for maternal risk factors. Data were compared between altitudes using -tests or chi-square, and by multiple or logistic regression analyses to adjust for risk factors and predict specific hypertensive or neonatal complications.
RESULTS
Statewide, high-altitude residence increased the frequency of each HDP disorder separately or all combined by 33%. High-altitude women studied longitudinally also had more HDP accompanied by higher blood pressures throughout pregnancy. The frequency of low birth weight infants (<2500 g), 5-min Apgar scores <7, and NICU admissions were also greater at high than low altitudes statewide, with the latter being accounted for by the increased incidence of HDP.
CONCLUSIONS
Residence at high altitude constitutes a risk factor for HDP and recommends increased clinical surveillance. The increased incidence also makes high altitude a natural laboratory for evaluating the efficacy of predictive biomarkers or new therapies for HDP.
目的
确定在科罗拉多州，与低海拔地区相比，高海拔（≥2500m，8250 英尺）是否会增加妊娠高血压疾病的全部范围（包括妊娠期高血压、有或无严重特征的子痫前期、子痫以及溶血、肝酶升高和血小板减少症（HELLP）综合征），且不受产妇背景特征的影响，如果是，其与新生儿健康的关系如何。
方法
本研究采用全州范围内的出生证明数据进行回顾性队列研究，比较了在 2007 年至 2016 年期间，617958 名居住在高海拔（>2500m）与低海拔（<2500m）地区且分娩的科罗拉多州妇女中，妊娠期高血压、子痫前期（有或无严重特征）、子痫、HELLP 综合征或所有 HDP 组合的发生频率。我们还比较了 2013 年和 2014 年在高海拔（>2500m）和低海拔（<1700m）地区分娩的 454 名科罗拉多州居民的血压在怀孕期间的纵向变化以及 HDP 的发生频率，并按产妇危险因素进行了匹配。通过 t 检验或卡方检验、多元或逻辑回归分析比较了不同海拔高度之间的数据，以调整危险因素并预测特定的高血压或新生儿并发症。
结果
全州范围内，高海拔地区居住使 HDP 各疾病单独或全部组合的发生频率增加了 33%。进行纵向研究的高海拔地区妇女在整个怀孕期间的 HDP 也伴有更高的血压。低出生体重儿（<2500g）、5 分钟 Apgar 评分<7 和新生儿重症监护病房（NICU）入院的频率在高海拔地区也高于低海拔地区，这主要归因于 HDP 的发生率增加。
结论
居住在高海拔地区是 HDP 的一个危险因素，建议加强临床监测。发病率的增加也使高海拔地区成为评估 HDP 预测生物标志物或新疗法疗效的天然实验室。
Zotero 插件