Department of Obstetrics and Gynecology, Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital, Nanjing, 210000, China.
Reprod Sci. 2024 Sep;31(9):2763-2770. doi: 10.1007/s43032-024-01529-4. Epub 2024 Apr 4.
To analyze the differences in risk factors and pregnancy outcomes between recurrent and initial pre-eclampsia(PE) with severe features. Data from recurrent (n = 128) and initial (n = 904) PE with severe features who terminated their pregnancy or gave birth at 20 weeks of gestation or later at the tertiary teaching hospital (Women's Hospital of Nanjing Medical University, Nanjing Women and Children's Healthcare Hospital) from January 2016 to December 2022 were collected. Risk factors for recurrent PE with severe features and differences in pregnancy outcomes between the two groups were assessed using the chi-square test, student t-test, or nonparametric test. Independent risk factors for recurrent PE with severe features were further analyzed by logistic regression. (1) Logistic regression analysis identified 3 independent risk factors for recurrent PE with severe features: history of cesarean section, rural residence and chronic hypertension. In addition, assisted reproductive technology (ART) is an independent risk factor for initial PE with severe features; (2) The incidence of oligohydramnios, chorioamnionitis, preterm birth, stillbirth, fetal growth restriction (FGR) and abnormal umbilical blood flow was higher in the recurrent PE with severe features group than in the initial PE with severe features group(P < 0.05). In contrast, the incidence of premature rupture of membrane (PROM) and postpartum hemorrhage (PPH) was higher in the group of initial PE with severe features(P < 0.05); (3) In the recurrent PE with severe features group, gestational age(GA) of birth and birth weight were lower than those in the initial PE with severe features group(P < 0.05). Also, the incidence of mild asphyxia, the rate of neonatal intensive care unit (NICU) hospitalization, length of stay in NICU, and the rate of abandoning treatment in the recurrent PE with severe features group were higher than those in the initial PE with severe features group(P < 0.05). 3 independent risk factors was identified for recurrent PE with severe features: history of cesarean section, rural residence and chronic hypertension. Women with recurrent PE with severe features are more likely to have adverse perinatal outcomes than those with initial PE with severe features.
分析重度早发型子痫前期（PE）复发与初发患者的危险因素及妊娠结局差异。方法：收集 2016 年 1 月至 2022 年 12 月于南京医科大学附属妇产医院（南京市妇幼保健院）因重度早发型 PE 行计划性剖宫产或终止妊娠孕周≥20 周的复发组（n=128）及初发组（n=904）患者的临床资料，采用卡方检验、t 检验或非参数检验比较两组患者的危险因素及妊娠结局，采用 Logistic 回归分析重度早发型 PE 复发的独立危险因素。结果：（1）Logistic 回归分析发现，重度早发型 PE 复发的 3 个独立危险因素为剖宫产史、农村户籍及慢性高血压。此外，辅助生殖技术（ART）是重度早发型 PE 的独立危险因素；（2）与初发组比较，复发组患者羊水过少、绒毛膜羊膜炎、早产、死胎、胎儿生长受限（FGR）及脐血流异常的发生率更高（P<0.05），而胎膜早破（PROM）及产后出血（PPH）的发生率更低（P<0.05）；（3）与初发组比较，复发组患者的出生孕周及出生体质量更低（P<0.05），且轻度窒息、新生儿重症监护病房（NICU）住院率、NICU 住院时间、放弃治疗率更高（P<0.05）。结论：重度早发型 PE 复发的独立危险因素为剖宫产史、农村户籍及慢性高血压。与初发组比较，重度早发型 PE 复发患者的围生儿结局更差。
