6579例妊娠合并高血压疾病孕妇危急情况的患病率及影响因素
Prevalence and the influencing factors for critical situation of 6 579 pregnant women with hypertensive disorders complicating pregnancy.
作者信息
Yan Xuemei, Kong Fanjuan, Wang Aihua, Li Fang, Chen Lizhang
机构信息
Department of Internal Medicine, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008.
Department of Information Management, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2021 Aug 28;46(8):814-821. doi: 10.11817/j.issn.1672-7347.2021.200601.
OBJECTIVES
Hypertensive disorders complicating pregnancy is a kind of disease that seriously endangers the health of pregnant women and fetuses with high incidence. This study aims to analyze the prevalence of pregnant women with hypertensive disorders complicating pregnancy and the influential factors for critical pregnant women, and to provide basis for intervention measures.
METHODS
In an institution-based cross-sectional study, 100 683 pregnant women, who gave birth in all maternal and child health hospitals of Hunan Province from January 1, 2012 to December 31, 2019, were collected, and 6 579 pregnant women with hypertensive disorders complicating pregnancy were monitored. All data were analyzed through SAS9.4 software. The basic situation, clinical data, outcome, and complications of pregnant women were analyzed, and the risk factors for critical pregnant women with hypertensive disorders complicating pregnancy were analyzed.
RESULTS
The prevalence rate of hypertensive disorder complicating pregnancy was increased from 4.3% in 2012 to 7.1% in 2019, and the proportion of hypertensive disorder complicating pregnant women with complications in the hypertensive disorder complicating pregnant women was increased from 28.1% in 2012 to 83.7% in 2019. Elderly pregnant women accounted for 22.2%, married women accounted for 99.9%, women with university degree accounted for 49.5%, one pregnancy accounted for 38%, and zero delivery accounted for 63.5%. In the past, 18.4% of pregnant women had more than one cesarean section, accounting for 18.4%. About 99.0% of pregnant women had 5-10 antenatal check-ups, 72.6% had complications, and 93.8% were terminated when they were discharged. The first 3 complications were anemia in 2 355 cases (29.3%), gestational diabetes in 1 886 cases (23.4%), and subclinical hypothyroidism in 947 cases (11.8%). Logistic regression analysis showed that uterine rupture, placental abruption, placenta previa, anemia, and heart disease were independent risk factors for critical pregnant women.
CONCLUSIONS
The prevalence of hypertensive disorders complicating pregnancy is on the rise. Pregnancy examination should be enhanced to identify the complications such as hypothyroidism, gestational diabetes, and anemia. Prevention and treatment measures should be actively taken for uterine rupture, placental abruption, placenta previa, anemia, and heart disease.
目的
妊娠期高血压疾病是一种发病率高、严重危及孕产妇及胎儿健康的疾病。本研究旨在分析妊娠期高血压疾病孕妇的患病率及重症孕妇的影响因素，为干预措施提供依据。
方法
采用基于机构的横断面研究，收集2012年1月1日至2019年12月31日在湖南省所有妇幼保健院分娩的100683例孕妇，监测6579例妊娠期高血压疾病孕妇。所有数据通过SAS9.4软件进行分析。分析孕妇的基本情况、临床资料、结局及并发症，分析妊娠期高血压疾病重症孕妇的危险因素。
结果
妊娠期高血压疾病患病率从2012年的4.3%上升至2019年的7.1%，妊娠期高血压疾病孕妇中合并并发症的孕妇比例从2012年的28.1%上升至2019年的83.7%。高龄孕妇占22.2%，已婚孕妇占99.9%，大学学历女性占49.5%，初产妇占38%，未产妇占63.5%。既往有18.4%的孕妇有1次以上剖宫产史，占18.4%。约99.0%的孕妇进行了5 - 10次产前检查，72.6%有并发症，93.8%出院时终止妊娠。前3位并发症依次为贫血2355例（29.3%）、妊娠期糖尿病1886例（23.4%）、亚临床甲状腺功能减退947例（11.8%）。Logistic回归分析显示，子宫破裂、胎盘早剥、前置胎盘、贫血和心脏病是重症孕妇的独立危险因素。
结论
妊娠期高血压疾病患病率呈上升趋势。应加强孕期检查，以识别甲状腺功能减退、妊娠期糖尿病和贫血等并发症。应积极采取针对子宫破裂、胎盘早剥、前置胎盘、贫血和心脏病的防治措施。
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