Wilson Dulaney A, Mateus Julio, Ash Emily, Turan Tanya N, Hunt Kelly J, Malek Angela M
Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Obstetrics & Gynecology, Maternal-Fetal Medicine Division, Atrium Health, Charlotte, NC 28204, USA.
Healthcare (Basel). 2024 Mar 6;12(5):597. doi: 10.3390/healthcare12050597.
Gestational hypertension, preeclampsia, eclampsia, and chronic hypertension (CHTN) are associated with adverse infant outcomes and disproportionately affect minoritized race/ethnicity groups. We evaluated the relationships between hypertensive disorders of pregnancy (HDP) and/or CHTN with infant mortality, preterm delivery (PTD), and small for gestational age (SGA) in a statewide cohort with a diverse racial/ethnic population. All live, singleton deliveries in South Carolina (2004-2016) to mothers aged 12-49 were evaluated for adverse outcomes: infant mortality, PTD (20 to less than <37 weeks) and SGA (<10th birthweight-for-gestational-age percentile). Logistic regression models adjusted for sociodemographic, behavioral, and clinical characteristics. In 666,905 deliveries, mothers had superimposed preeclampsia (HDP + CHTN; 1.0%), HDP alone (8.0%), CHTN alone (1.8%), or no hypertension (89.1%). Infant mortality risk was significantly higher in deliveries to women with superimposed preeclampsia, HDP, and CHTN compared with no hypertension (relative risk [RR] = 1.79, 1.39, and 1.48, respectively). After accounting for differing risk by race/ethnicity, deliveries to women with HDP and/or CHTN were more likely to result in PTD (RRs ranged from 3.14 to 5.25) or SGA (RRs ranged from 1.67 to 3.64). As CHTN, HDP and superimposed preeclampsia confer higher risk of adverse outcomes, prevention efforts should involve encouraging and supporting mothers in mitigating modifiable cardiovascular risk factors.
妊娠期高血压、子痫前期、子痫和慢性高血压（CHTN）与不良婴儿结局相关，并且对少数种族/族裔群体的影响尤为严重。我们在一个具有不同种族/族裔人口的全州队列中，评估了妊娠高血压疾病（HDP）和/或CHTN与婴儿死亡率、早产（PTD）和小于胎龄儿（SGA）之间的关系。对南卡罗来纳州（2004 - 2016年）年龄在12 - 49岁母亲的所有活产单胎分娩进行不良结局评估：婴儿死亡率、PTD（20至小于37周）和SGA（出生体重低于胎龄第10百分位数）。逻辑回归模型对社会人口统计学、行为和临床特征进行了调整。在666,905例分娩中，母亲患有叠加子痫前期（HDP + CHTN；1.0%）、单纯HDP（8.0%）、单纯CHTN（1.8%）或无高血压（89.1%）。与无高血压相比，患有叠加子痫前期、HDP和CHTN的女性分娩时婴儿死亡风险显著更高（相对风险[RR]分别为1.79、1.39和1.48）。在考虑种族/族裔的不同风险后，患有HDP和/或CHTN的女性分娩更有可能导致PTD（RR范围为3.14至5.25）或SGA（RR范围为1.67至3.64）。由于CHTN、HDP和叠加子痫前期会带来更高的不良结局风险，预防措施应包括鼓励和支持母亲减轻可改变的心血管危险因素。
