Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China.
Department of Obstetrics and Gynecology, Nanfang Hospital, Guangzhou, Guangdong, China.
BMC Pregnancy Childbirth. 2023 Nov 7;23(1):773. doi: 10.1186/s12884-023-06073-8.
Although the majority of pregnancies with preeclampsia are characterised by elevated blood pressure, preeclampsia is often associated with nephrotic syndrome with similar symptoms such as high proteinuria and bilateral lower limb oedema. In this study, we compared the maternal-foetal outcomes of pregnant women with preeclampsia in a population with nephrotic syndrome and explored the factors that contribute to the corresponding outcomes and disease development.
A total of 90 pregnant women were included in this study, of whom 30 had nephrotic syndrome and were diagnosed with preeclampsia during pregnancy, and 60 had nephrotic syndrome alone. Descriptive statistical analyses of baseline data were performed to analyse the effect of combined preeclampsia on maternal and foetal pregnancy outcomes using unadjusted and adjusted logistic regression models.
In this study, the baseline data of the two study populations demonstrated no differences except for the history of caesarean section and 24-h proteinuria results, which were significantly different (P < 0.05). The risk of preterm birth in the nephrotic syndrome with preeclampsia group was 8.25 (95% CI:3.041-22.084 P < 0.05); for a low birth weight, the risk was 6.00 (95% CI:2.302-15.638 P < 0.05); for foetal distress,the risk was 5.667 (95% CI:2.070-15.514 P < 0.05); and the risk of foetal birth restriction was 7.429 (95% CI: 2.642-20.885 P < 0.05). A risk-based analysis of adverse maternal outcomes yielded a risk of miscarriage of 2.200 (95% CI: 0.584-8.291; P > 0.05). After adjusting the model for each outcome, significant risks of preterm labour, foetal birth restriction, and low birth weight were revealed (P < 0.05).
Combined preeclampsia has a significantly higher risk of adverse pregnancy outcomes for the foetus.Therefore, the prevention and control of eclampsia in pregnant women should be improved to ensure maternal and neonatal health.
虽然大多数子痫前期患者的特征是血压升高，但子痫前期常伴有肾病综合征，具有相似的症状，如大量蛋白尿和双侧下肢水肿。在这项研究中，我们比较了患有肾病综合征的孕妇中伴有子痫前期的患者与单纯肾病综合征患者的母婴结局，并探讨了导致相应结局和疾病发展的因素。
本研究共纳入 90 名孕妇，其中 30 名患有肾病综合征并在怀孕期间被诊断为子痫前期，60 名仅患有肾病综合征。采用未调整和调整后的逻辑回归模型对基线数据进行描述性统计分析，以分析合并子痫前期对母婴妊娠结局的影响。
在这项研究中，除剖宫产史和 24 小时尿蛋白结果外，两组研究人群的基线数据没有差异，这两项差异具有统计学意义（P<0.05）。肾病综合征合并子痫前期组早产的风险为 8.25（95%CI：3.041-22.084 P<0.05）；低出生体重的风险为 6.00（95%CI：2.302-15.638 P<0.05）；胎儿窘迫的风险为 5.667（95%CI：2.070-15.514 P<0.05）；胎儿生长受限的风险为 7.429（95%CI：2.642-20.885 P<0.05）。对不良母婴结局进行风险分析得出，流产的风险为 2.200（95%CI：0.584-8.291；P>0.05）。调整每个结局的模型后，早产、胎儿生长受限和低出生体重的风险显著增加（P<0.05）。
合并子痫前期会显著增加胎儿不良妊娠结局的风险。因此，应加强对孕妇子痫前期的预防和控制，以保障母婴健康。
