Stefanska Katarzyna A, Zielinski Maciej, Jassem-Bobowicz Joanna, Zamkowska Dorota, Adamski Przemyslaw, Piekarska Karolina, Jankowiak Martyna, Leszczynska Katarzyna, Swiatkowska-Stodulska Renata, Preis Krzysztof, Trzonkowski Piotr, Marek-Trzonkowska Natalia
Department of Obstetrics, Medical University of Gdansk, Poland.
Department of Medical Immunology, Medical University of Gdansk, Poland.
Ginekol Pol. 2021 Jun 9. doi: 10.5603/GP.a2021.0101.
Preeclampsia (PE) affects 2-5% of pregnant women. Hypertensive disorders of pregnancy are associated with adverse maternal and perinatal outcomes.
This study included 88 women showing gestational hypertension (GH) or PE symptoms, and their newborns.
The rate of FGR was 43% for mothers with PE, compared to 8% with GH. The association was significant, p = < 0.001 but with moderate strength, Cramer's V = 0.40. The risk of FGR increased nine times when PE occurred, as the odds ratio was 9.25 (CI: 2.46-34.83), p = 0.001. PE was associated with FGR risk if delivery time was less than 34 weeks compared to a delivery time of more than 34 weeks. This was 82% of FGR cases for < 34 weeks, compared with 35% of cases in > 34 group, (p = 0.001; Cramer's V = 0.50). PE was also associated (p = 0.01, Cramer's V = 0.27) with the type of delivery, as the caesarean section rate was 74%, compared to 50% in the GH group. This made it three times higher the likelihood of delivery by caesarean section, as the odds ratio was 3.10 (CI: 1.24-7.75), p=0,02. Delivery time was significantly (p < 0.001) shortened to 38 weeks (27-41), compared to 40 weeks (38-42) GH mothers. There was no distinction in median age for PE and GH mothers (p = 0.124). The overall clinical status of neonates was proportional despite the mother's PE. The sum of Apgar points in the first, and then the second to third minute, did not differ significantly, p = 0.370 and 0.560, respectively. The number of peripheral blood platelets and leucocytes was not reduced (p = 0.821 and 0.534) in infants when the mother suffered from PE.
The prediction of adverse maternal outcomes from hypertensive diseases of pregnancy is key to optimal management, including the timing of delivery and planning for the most appropriate place of care.
子痫前期(PE)影响2%-5%的孕妇。妊娠高血压疾病与不良的孕产妇和围产期结局相关。
本研究纳入了88名出现妊娠期高血压(GH)或PE症状的女性及其新生儿。
PE母亲的胎儿生长受限(FGR)发生率为43%,而GH母亲为8%。两者关联显著,p = < 0.001,但强度中等,克莱姆相关系数V = 0.40。PE发生时,FGR风险增加9倍,优势比为9.25(可信区间:2.46 - 34.83),p = 0.001。与分娩时间超过34周相比,分娩时间小于34周时,PE与FGR风险相关。< 34周时FGR病例占82%,而> 34周组为35%,(p = 0.001;克莱姆相关系数V = 0.50)。PE还与分娩方式相关(p = 0.01,克莱姆相关系数V = 0.27),PE组剖宫产率为74%,而GH组为50%。剖宫产分娩的可能性高出3倍,优势比为3.10(可信区间:1.24 - 7.75),p = 0.02。与GH母亲的40周(38 - 42)相比,PE母亲的分娩时间显著缩短(p < 0.001)至38周(27 - 41)。PE和GH母亲的中位年龄无差异(p = 0.124)。尽管母亲患有PE,但新生儿的总体临床状况成比例。出生后第1分钟以及随后第2至3分钟的阿氏评分总和无显著差异,p分别为0.370和0.560。母亲患有PE时,婴儿外周血血小板和白细胞数量未减少(p = 0.821和0.534)。
预测妊娠高血压疾病的不良孕产妇结局是优化管理的关键,包括分娩时机和规划最合适的护理地点。