2000 年至 2018 年妊娠高血压疾病分娩的趋势和结局：一项重复横断面研究。
Trends and outcomes for deliveries with hypertensive disorders of pregnancy from 2000 to 2018: A repeated cross-sectional study.
机构信息
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA.
University of California San Francisco School of Medicine, San Francisco, California, USA.
出版信息
BJOG. 2022 Jun;129(7):1050-1060. doi: 10.1111/1471-0528.17038. Epub 2022 Jan 4.
OBJECTIVE
To analyse trends, risk factors, and outcomes related to hypertensive disorders of pregnancy (HDP).
DESIGN
Repeated cross-sectional.
SETTING
US delivery hospitalisations.
POPULATION
Delivery hospitalisations in the 2000-2018 National Inpatient Sample.
METHODS
US hospital delivery hospitalisations with HDP were analysed. Several trends were analysed: (i) the proportion of deliveries by year with HDP, (ii) the proportion of deliveries with HDP risk factors and (iii) adverse outcomes associated with HDP including maternal stroke, acute renal failure and acute liver injury. Risk ratios were determined using regression models with HDP as the exposure of interest.
MAIN OUTCOME MEASURES
Prevalence of HDP, risk factors for HDP and associated adverse outcomes.
RESULTS
Of 73.1 million delivery hospitalisations, 7.7% had an associated diagnosis of HDP. Over the study period, HDP doubled from 6.0% of deliveries in 2000 to 12.0% in 2018. The proportion of deliveries with risk factors for HDP increased from 9.6% in 2000 to 24.6% in 2018. In adjusted models, HDP were associated with increased stroke (aRR [adjusted risk ratio] 15.9, 95% CI 14.8-17.1), acute renal failure (aRR 13.8, 95% CI 13.5-14.2) and acute liver injury (aRR 1.2, 95% CI 1.2-1.3). Among deliveries with HDP, acute renal failure and acute liver injury increased; in comparison, stroke decreased.
CONCLUSION
Hypertensive disorders of pregnancy increased in the setting of risk factors for HDP becoming more common, whereas stroke decreased.
TWEETABLE ABSTRACT
While hypertensive disorders of pregnancy increased from 2000 to 2018, stroke appears to be decreasing.
目的
分析与妊娠高血压疾病（HDP）相关的趋势、风险因素和结局。
设计
重复横断面研究。
设置
美国分娩医院。
人群
2000 年至 2018 年全国住院患者样本中的分娩住院患者。
方法
分析 HDP 美国住院分娩患者。分析了几种趋势：（i）每年 HDP 分娩的比例，（ii）HDP 风险因素的分娩比例，以及（iii）与 HDP 相关的不良结局，包括产妇中风、急性肾衰竭和急性肝损伤。使用以 HDP 为暴露因素的回归模型确定风险比。
主要观察指标
HDP 的患病率、HDP 的风险因素以及相关的不良结局。
结果
在 7310 万分娩住院患者中，有 7.7%的患者伴有 HDP 诊断。在研究期间，HDP 从 2000 年的 6.0%增加到 2018 年的 12.0%，增加了一倍。有 HDP 风险因素的分娩比例从 2000 年的 9.6%增加到 2018 年的 24.6%。在调整模型中，HDP 与中风（调整风险比[aRR]15.9，95%置信区间[CI]14.8-17.1）、急性肾衰竭（aRR 13.8，95%CI 13.5-14.2）和急性肝损伤（aRR 1.2，95%CI 1.2-1.3）的发生风险增加相关。在 HDP 分娩中，急性肾衰竭和急性肝损伤增加；相比之下，中风减少。
结论
在 HDP 风险因素变得更加普遍的情况下，妊娠高血压疾病增加，而中风则减少。
推文摘要
虽然妊娠高血压疾病从 2000 年到 2018 年有所增加，但中风似乎在减少。
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