Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Provincial Key Clinical Specialty of Woman and Child Health, Guangdong, China.
J Clin Hypertens (Greenwich). 2022 Jun;24(6):770-778. doi: 10.1111/jch.14494. Epub 2022 Jun 1.
Women's blood pressure (BP) changes throughout pregnancy. The effect of BP trajectories on preterm delivery is not clear. The authors aim to evaluate the association between maternal BP trajectories during pregnancy and preterm delivery. The authors studied pregnant women included in the Born in Guangzhou Cohort Study in China between February 2012 and June 2016. Maternal BP was measured at antenatal visits between 13 and 40 gestational weeks, and gestational age of delivery data was collected. The authors used linear mixed models to capture the BP trajectories of women with term, and spontaneous and iatrogenic preterm delivery. BP trajectories of women with various gestational lengths (34, 35, 36, 37, 38, 39, 40 weeks) were compared. Of the 17 426 women included in the analysis, 618 (3.55%) had spontaneous preterm delivery; 158 (.91%) had iatrogenic preterm delivery; and 16 650 (95.55%) women delivered at term. The BP trajectories were all J-shaped curves for different delivery types. Women with iatrogenic preterm delivery had the highest mean BP from 13 weeks till delivery, followed by those with spontaneous preterm delivery and term delivery (p < .001). Trajectory analysis stratified by maternal parity showed similar results for nulliparous and multiparous women. Excluding women with pre-eclampsia and gestational hypertension (GH) significantly attenuated the aforementioned association. Also, women with shorter gestational length tend to have higher BP trajectories during pregnancy. In conclusion, Women with spontaneous preterm delivery have a higher BP from 13 weeks till delivery than women with term delivery, while women with iatrogenic preterm delivery have the highest BP.
女性的血压（BP）在整个怀孕期间会发生变化。BP 轨迹对早产的影响尚不清楚。作者旨在评估妊娠期间母体 BP 轨迹与早产之间的关系。作者研究了 2012 年 2 月至 2016 年 6 月期间参加中国广州出生队列研究的孕妇。在妊娠 13 至 40 周的产前检查期间测量了孕妇的 BP，并收集了分娩时的妊娠年龄数据。作者使用线性混合模型来捕捉足月、自发性和医源性早产孕妇的 BP 轨迹。比较了具有不同妊娠长度（34、35、36、37、38、39、40 周）的女性的 BP 轨迹。在分析中，包括 17426 名妇女，其中 618 名（3.55%）自发性早产；158 名（0.91%）医源性早产；16650 名（95.55%）足月分娩。对于不同的分娩类型，BP 轨迹均呈 J 形曲线。医源性早产的女性从 13 周开始到分娩时的平均 BP 最高，其次是自发性早产和足月分娩的女性（p < 0.001）。根据产妇的产次进行轨迹分析，显示初产妇和经产妇有相似的结果。排除子痫前期和妊娠期高血压（GH）患者后，上述关联明显减弱。此外，妊娠时间较短的女性在怀孕期间往往有更高的 BP 轨迹。总之，与足月分娩的女性相比，自发性早产的女性从 13 周开始到分娩时的 BP 更高，而医源性早产的女性 BP 最高。
