Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Division of Obstetrics and Gynecology, Naradhiwas Rajanagarindra Hospital, Narathiwat, Thailand.
BMJ Open. 2022 Jun 15;12(6):e055534. doi: 10.1136/bmjopen-2021-055534.
To assess the levels of blood pressure, cardiovascular biomarkers and their correlations measured within 7 years postpartum in women with previous pre-eclamptic pregnancies compared with women with previous normotensive pregnancies.
Cross-sectional study.
Two tertiary hospitals in the southern region of Thailand.
Women with pre-eclamptic and normotensive pregnancies in the past 7 years were enrolled from 1 October 2019 to 30 April 2021. Eligible women were interviewed, examined for body mass index (BMI) and blood pressure, and donated morning spot urine and blood samples.
Serum high-sensitivity C reactive protein, creatinine, fasting blood glucose (FBS), glycated haemoglobin (HbA1c), low-density lipoprotein (LDL) cholesterol, urine microalbumin to creatinine ratio (UACR) and sodium were measured. Group differences in biomarkers were tested using unpaired t-test, Wilcoxon rank-sum test or χ test. The levels of blood pressure and biomarkers between the two study groups at <2 years, 2-4 years and >4 years were also compared. The correlations between blood pressure and biomarkers were analysed using Pearson's correlation and partial correlation methods.
From 206 women included in the analysis, 88 had pre-eclamptic pregnancies and 118 had normotensive pregnancies. Compared with women with previous normotensive pregnancies, women with previous pre-eclamptic pregnancies had significantly increased rates of hypertension (31.8% vs 7.6%, p<0.001) and obesity (55.7% vs 40.7%, p=0.038), as well as higher serum levels of FBS (p<0.001), HbA1c (p<0.001), LDL cholesterol (p=0.03), creatinine (p<0.001) and UACR (p<0.001). Correlation coefficients of BMI, serum creatinine and UACR with blood pressure ranged from 0.27 to 0.31.
The risk of hypertension after a pre-eclamptic pregnancy increased. Blood pressure measurement combined with BMI, serum creatinine and UACR screening at least once during 7 years postpartum is suggested for early detection of cardiovascular risk.
评估过去 7 年内患有子痫前期妊娠的女性与既往血压正常妊娠的女性在产后 7 年内测量的血压、心血管生物标志物及其相关性水平。
横断面研究。
泰国南部的两家三级医院。
2019 年 10 月 1 日至 2021 年 4 月 30 日期间，招募了过去 7 年内患有子痫前期和血压正常妊娠的女性。对符合条件的女性进行访谈、检查体重指数（BMI）和血压，并采集早晨的尿液和血液样本。
检测血清高敏 C 反应蛋白、肌酐、空腹血糖（FBS）、糖化血红蛋白（HbA1c）、低密度脂蛋白（LDL）胆固醇、尿微量白蛋白与肌酐比值（UACR）和钠。使用配对 t 检验、Wilcoxon 秩和检验或卡方检验比较生物标志物的组间差异。比较两组研究对象在产后<2 年、2-4 年和>4 年的血压和生物标志物水平。使用 Pearson 相关和偏相关方法分析血压和生物标志物之间的相关性。
在纳入分析的 206 名女性中，88 名患有子痫前期妊娠，118 名患有血压正常妊娠。与既往血压正常妊娠的女性相比，既往患有子痫前期妊娠的女性高血压发生率（31.8% vs. 7.6%，p<0.001）和肥胖率（55.7% vs. 40.7%，p=0.038）显著增加，且血清 FBS（p<0.001）、HbA1c（p<0.001）、LDL 胆固醇（p=0.03）、肌酐（p<0.001）和 UACR（p<0.001）水平升高。BMI、血清肌酐和 UACR 与血压的相关系数范围为 0.27 至 0.31。
子痫前期妊娠后高血压的风险增加。建议在产后 7 年内至少进行一次血压测量，同时结合 BMI、血清肌酐和 UACR 筛查，以早期发现心血管风险。
