妊娠高血压与正常血压孕妇 2 年后的儿童生长结局：P4 研究。
Childhood growth outcomes 2 years after hypertensive versus normotensive pregnancy: a P4 study.
机构信息
Discipline of Paediatrics and Child Health, School of Clinical Medicine, UNSW Medicine and Health, Sydney, NSW, Australia.
Department of Women's and Children's Health, St George Hospital, Sydney, NSW, Australia.
出版信息
Pediatr Res. 2024 Jan;95(1):275-284. doi: 10.1038/s41390-023-02789-7. Epub 2023 Sep 6.
BACKGROUND
Intrauterine exposure to hypertensive disorders of pregnancy, including gestational hypertension (GH) and preeclampsia (PE), may influence infant growth and have long-term health implications. This study aimed to compare growth outcomes of infants exposed to a normotensive pregnancy (NTP), GH, or PE from birth to 2 years.
METHODS
Infants were children of women enroled in the prospective Postpartum Physiology, Psychology and Paediatric (P4) cohort study who had NTP, GH or PE. Birth, 6-month (age-corrected) and 2-year (age-corrected) weight z-scores, change in weight z-scores, rapid weight gain (≥0.67 increase in weight z-score) and conditional weight gain z-scores were calculated to assess infant growth (NTP = 240, GH = 19, PE = 66).
RESULTS
Infants exposed to PE compared to NTP or GH had significantly lower birth weight and length z-scores, but there were no differences in growth outcomes at 6 months or 2 years. GH and PE-exposed infants had significantly greater weight z-score gain [95% CI] (PE = 0.93 [0.66-1.18], GH = 1.03 [0.37-1.68], NTP = 0.45 [0.31-0.58], p < 0.01) and rapid weight gain (GH = 63%, PE = 59%, NTP = 42%, p = 0.02) from birth to 2 years, which remained significant for PE-exposed infants after confounder adjustment.
CONCLUSION
In this cohort, GH and PE were associated with accelerated infant weight gain that may increase future cardiometabolic disease risk.
IMPACT
Preeclampsia exposed infants were smaller at birth, compared with normotensive pregnancy and gestational hypertension exposed infants, but caught up in growth by 2 years of age. Both preeclampsia and gestational hypertension exposed infants had significantly accelerated weight gain from birth to 2 years, which remained significant for preeclampsia exposed infants after adjustment for confounders including small for gestational age. Monitoring of growth patterns in infants born following exposure to a hypertensive disorder of pregnancy may be indicated to prevent accelerated weight gain trajectories and obesity.
背景
宫内暴露于妊娠高血压疾病，包括妊娠期高血压（GH）和子痫前期（PE），可能会影响婴儿的生长发育，并对其长期健康产生影响。本研究旨在比较出生至 2 岁时暴露于正常妊娠（NTP）、GH 或 PE 的婴儿的生长结局。
方法
本研究纳入前瞻性产后生理、心理和儿科（P4）队列研究中孕妇所生的婴儿，这些孕妇患有 NTP、GH 或 PE。计算出生时、6 月龄（年龄校正）和 2 岁时（年龄校正）体重 z 评分、体重 z 评分变化、体重快速增长（体重 z 评分增加≥0.67）和条件体重增长 z 评分，以评估婴儿的生长情况（NTP=240 例，GH=19 例，PE=66 例）。
结果
与 NTP 或 GH 相比，PE 暴露的婴儿出生体重和身长 z 评分明显较低，但在 6 个月或 2 岁时生长结局无差异。GH 和 PE 暴露的婴儿体重 z 评分增加明显更大[95%CI]（PE=0.93[0.66-1.18]，GH=1.03[0.37-1.68]，NTP=0.45[0.31-0.58]，p<0.01），从出生到 2 岁时体重快速增长（GH=63%，PE=59%，NTP=42%，p=0.02），PE 暴露的婴儿在调整混杂因素后仍有显著差异。
结论
在本队列中，GH 和 PE 与婴儿体重快速增长相关，这可能增加未来患心血管代谢疾病的风险。
影响
与正常妊娠和妊娠期高血压暴露的婴儿相比，PE 暴露的婴儿出生时体重较小，但在 2 岁时赶上了生长。从出生到 2 岁时，GH 和 PE 暴露的婴儿体重增长明显加快，在调整了包括小于胎龄在内的混杂因素后，PE 暴露的婴儿仍有显著差异。监测患有妊娠高血压疾病婴儿的生长模式可能有助于预防体重快速增长轨迹和肥胖。
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