Division of Public Health, Hygiene and Epidemiology, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan.
Hypertens Res. 2022 Aug;45(8):1298-1309. doi: 10.1038/s41440-022-00965-6. Epub 2022 Jun 20.
Hypertensive disorders of pregnancy increase the risk of adverse maternal and fetal outcomes. In 2018, the Japanese classification of hypertensive disorders of pregnancy was standardized with those of other countries, and a hypertensive disorder of pregnancy was considered to be present if hypertension existed during pregnancy and up to 12 weeks after delivery. Strategies for the prevention of hypertensive disorders of pregnancy have become much clearer, but further research is needed on appropriate subjects and methods of administration, and these have not been clarified in Japan. Although guidelines for the use of antihypertensive drugs are also being studied and standardized with those of other countries, the use of calcium antagonists before 20 weeks of gestation is still contraindicated in Japan because of the safety concerns that were raised regarding possible fetal anomalies associated with their use at the time of their market launch. Chronic hypertension is now included in the definition of hypertensive disorders of pregnancy, and blood pressure measurement is a fundamental component of the diagnosis of hypertensive disorders of pregnancy. Out-of-office blood pressure measurements, including ambulatory and home blood pressure measurements, are important for pregnant and nonpregnant women. Although conditions such as white-coat hypertension and masked hypertension have been reported, determining their occurrence in pregnancy is complicated by the gestational week. This narrative review focused on recent reports on hypertensive disorders of pregnancy, including those related to blood pressure measurement and classification.
妊娠高血压疾病会增加母婴不良结局的风险。2018 年，日本妊娠高血压疾病分类与其他国家标准化，认为妊娠期间和产后 12 周内存在高血压即为妊娠高血压疾病。妊娠高血压疾病的预防策略已经变得更加清晰，但在日本，仍需要进一步研究适当的研究对象和管理方法，这些问题尚未得到明确。尽管与其他国家一样，也在研究和标准化降压药物的使用指南，但由于在上市时使用钙拮抗剂可能与胎儿畸形相关的安全性问题，日本仍禁止在妊娠 20 周之前使用钙拮抗剂。现在，慢性高血压也被纳入妊娠高血压疾病的定义，血压测量是妊娠高血压疾病诊断的基本组成部分。包括动态血压和家庭血压测量在内的诊室外血压测量对孕妇和非孕妇都很重要。尽管已经报道了白大衣高血压和隐匿性高血压等情况，但由于妊娠周数的影响，确定其在妊娠中的发生情况变得复杂。本综述重点介绍了妊娠高血压疾病的最新报告，包括与血压测量和分类相关的报告。
