Lenin Audrin, Vijayaselvi Reeta, Rajan Sudha Jasmine, Rathore Swati, Abraham Kavitha, Yadav Bijesh, Satyendra Sowmya
Department of Medicine Unit 3 and Obstetric Medicine, Christian Medical College, Vellore, Tamil Nadu 632004 India.
Department of Obstetrics Unit 4, Christian Medical College, Vellore, Tamil Nadu 632004 India.
J Obstet Gynaecol India. 2022 Aug;72(Suppl 1):139-145. doi: 10.1007/s13224-021-01576-w. Epub 2021 Oct 15.
To examine the prevalence, etiology, and clinical outcomes of secondary hypertension in pregnancy in a high-risk tertiary care hospital.
This retrospective study used data from patient records between January 2015 and July 2018. Of 52,293 pregnant women admitted during this period, those with hypertension were included. Patient demographics, diagnosis of secondary hypertension, investigations, suspected etiologies of secondary hypertension, maternal and neonatal outcomes and discharge conditions were included.
The prevalence of secondary hypertension and causes were measured. Univariate followed by multivariate analyses were done to look for associated maternal and neonatal outcomes.
Among patients with chronic hypertension in pregnancy, 13.7% had secondary causes, of which renal and cardiac causes were the commonest. The incidence of severe pre-eclampsia (40.5%) among patients with secondary hypertension was higher in patients with systolic blood pressures more than 140 mm of Hg than in those with systolic blood pressures lower than 140 mm of Hg (odds ratio [OR]: 4.92, confidence interval [CI]: 1.7-14.16, : 0.002) irrespective of etiology. Pre-eclampsia predisposed to maternal acute kidney injury (OR: 1.23, CI: 1.04-1.45, : 0.003), low birthweight (OR: 4.69, CI: 1.44-11.9, : 0.006), preterm delivery (OR: 4.69, CI: 1.78-12.34, : 0.001), and neonatal death (OR: 5.19, CI: 0.97-27.6, : 0.04).
The prevalence of hypertension in pregnancy was 10.3%; among them, the prevalence of secondary hypertension was 1.46%. Uncontrolled secondary hypertension was associated with poor maternal and neonatal outcomes. Strict control of blood pressure in secondary hypertension in pregnancy ensured better outcomes.
在一家高风险三级护理医院中，研究妊娠继发性高血压的患病率、病因及临床结局。
这项回顾性研究使用了2015年1月至2018年7月期间患者记录中的数据。在此期间收治的52293名孕妇中，纳入了患有高血压的孕妇。记录了患者的人口统计学资料、继发性高血压的诊断、检查、继发性高血压的疑似病因、母婴结局及出院情况。
测量继发性高血压的患病率及病因。进行单因素分析，随后进行多因素分析，以寻找相关的母婴结局。
在妊娠慢性高血压患者中，13.7%有继发性病因，其中肾脏和心脏病因最为常见。无论病因如何，继发性高血压患者中收缩压高于140 mmHg的患者发生重度子痫前期的发生率（40.5%）高于收缩压低于140 mmHg的患者（比值比[OR]：4.92，置信区间[CI]：1.7 - 14.16，P：0.002）。子痫前期易导致孕产妇急性肾损伤（OR：1.23，CI：1.04 - 1.45，P：0.003）、低出生体重（OR：4.69，CI：1.44 - 11.9，P：0.006）、早产（OR：4.69，CI：1.78 - 12.34，P：0.001）及新生儿死亡（OR：5.19，CI：0.97 - 27.6，P：0.04）。
妊娠高血压的患病率为10.3%；其中，继发性高血压的患病率为1.46%。未控制的继发性高血压与母婴不良结局相关。严格控制妊娠继发性高血压的血压可确保更好的结局。
