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妊娠高血压疾病的母婴围产期结局:来自越南国家妇产科医院的见解。

Maternal and perinatal outcomes of hypertensive disorders in pregnancy: Insights from the National Hospital of Obstetrics and Gynecology in Vietnam.

机构信息

Hanoi Medical University, Hanoi, Vietnam.

National Hospital of Obstetrics and Gynecology, Hanoi, Vietnam.

出版信息

PLoS One. 2024 Jan 31;19(1):e0297302. doi: 10.1371/journal.pone.0297302. eCollection 2024.

Abstract

INTRODUCTION

Hypertension is the common disorder encountered during pregnancy, complicating 5% to 10% of all pregnancies. Hypertensive disorders in pregnancy (HDP) are also a leading cause of maternal and perinatal morbidity and mortality. The majority of feto-maternal complications due to HPD have occurred in the low- and middle-income countries. However, few studies have been done to assess the feto-maternal outcomes and the predictors of adverse perinatal outcome among women with HDP in these countries.

METHODS

A prospective cohort study was conducted on women with HDP who were delivered at National Hospital of Obstetrics and Gynecology, Vietnam from March 2023 to July 2023. Socio-demographic and obstetrics characteristics, and feto-maternal outcomes were obtained by trained study staff from interviews and medical records. Statistical analysis was performed using SPSS version 26.0. Bivariate and multiple logistic regressions were done to determine factors associated with adverse perinatal outcome. A 95% confidence interval not including 1 was considered statically significant.

RESULTS

A total of 255 women with HDP were enrolled. Regarding adverse maternal outcomes, HELLP syndrome (3.9%), placental abruption (1.6%), and eclampsia (1.2%) were three most common complications. There was no maternal death associated with HDP. The most common perinatal complication was preterm delivery developed in 160 (62.7%) of neonates. Eight stillbirths (3.1%) were recorded whereas the perinatal mortality was 6.3%. On bivariate logistic regression, variables such as residence, type of HDP, highest systolic BP, highest diastolic BP, platelet count, severity symptoms, and birth weight were found to be associated with adverse perinatal outcome. On multiple logistic regression, highest diastolic BP, severity symptoms, and birth weight were found to be independent predictors of adverse perinatal outcome.

CONCLUSION

Our study showed lower prevalence of stillbirth, perinatal mortality, and maternal complication compared to some previous studies. Regular antenatal care and early detection of abnormal signs during pregnancy help to devise an appropriate monitoring and treatment strategies for each women with HDP.

摘要

简介

高血压是怀孕期间常见的疾病,占所有妊娠的 5%至 10%。妊娠高血压疾病(HDP)也是导致孕产妇和围产儿发病率和死亡率的主要原因。由于 HPD 导致的大多数母婴并发症发生在中低收入国家。然而,很少有研究评估这些国家 HDP 妇女的母婴结局以及不良围产儿结局的预测因素。

方法

一项前瞻性队列研究于 2023 年 3 月至 7 月在越南国家妇产科医院对 HDP 产妇进行。通过培训的研究人员从访谈和病历中获取社会人口统计学和产科特征以及母婴结局。使用 SPSS 版本 26.0 进行统计分析。进行了双变量和多逻辑回归分析,以确定与不良围产儿结局相关的因素。不包括 1 的 95%置信区间被认为具有统计学意义。

结果

共纳入 255 例 HDP 产妇。在不良母亲结局方面,HELLP 综合征(3.9%)、胎盘早剥(1.6%)和子痫(1.2%)是三种最常见的并发症。没有与 HDP 相关的孕产妇死亡。最常见的围产儿并发症是 160 例(62.7%)新生儿早产。记录了 8 例死产(3.1%),围产儿死亡率为 6.3%。在双变量逻辑回归中,居住地、HDP 类型、最高收缩压、最高舒张压、血小板计数、症状严重程度和出生体重等变量与不良围产儿结局相关。在多变量逻辑回归中,最高舒张压、症状严重程度和出生体重被发现是不良围产儿结局的独立预测因素。

结论

与一些先前的研究相比,我们的研究显示死产、围产儿死亡率和产妇并发症的发生率较低。定期产前保健和早期发现妊娠期间的异常迹象有助于为每位 HDP 妇女制定适当的监测和治疗策略。

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