Anesthesiology, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania, United States of America.
Obstetrics and Gynecology, University of Pittsburgh Medical Center, Harrisburg, Pennsylvania, United States of America.
PLoS One. 2024 Jul 8;19(7):e0302019. doi: 10.1371/journal.pone.0302019. eCollection 2024.
Hyponatremia, though common in women with preeclampsia, has not been well studied. Our primary objectives are to assess the clinical characteristics and emergency therapy applied to subjects diagnosed with preeclampsia. We hypothesize that hyponatremia present in preeclamptic patients with severe features is associated with greater use of emergency hypertensives, antenatal steroids, and cesarean delivery. This is a retrospective descriptive study utilizing an electronic health record database (TriNetX ®). We collected and evaluated the following data of subjects aged 15 to 54 years with preeclampsia with severe features diagnosis: demographics, diagnostic codes, medication codes, procedure codes, deaths, and laboratory results. A total of 2,901 subjects [215 (7.4%)] with a sodium level below 134 mEq/L and [2686 (92.6%)] with a sodium level above 135 mEq/L were included. A higher proportion of subjects in the below 134 sodium group received emergency antihypertensives [165 (76.7%) versus 1811 (67.4%), p = 0.01], antenatal steroids [103 (47.9%) versus 953 (35.5%), p = 0.001], and cesarean section [27 (12.6%) versus 97 (3.6%), p = <0.001]. We found that hyponatremia may be associated with emergency antihypertensive use, antenatal steroid use, and cesarean section in patients with preeclampsia with severe features. Future research is needed to determine if routine sodium levels assessed in preeclamptic subjects with severe features identify subjects at risk of receiving these treatments.
低钠血症虽然在子痫前期妇女中很常见，但尚未得到很好的研究。我们的主要目标是评估诊断为子痫前期的患者的临床特征和紧急治疗。我们假设，伴有严重特征的子痫前期患者的低钠血症与更频繁地使用紧急降压药、产前类固醇和剖宫产有关。这是一项使用电子病历数据库（TriNetX ®）的回顾性描述性研究。我们收集并评估了以下数据：年龄在 15 至 54 岁之间、伴有严重特征的子痫前期患者的人口统计学资料、诊断代码、药物代码、手术代码、死亡和实验室结果。共有 2901 名患者（215 名，7.4%）的钠离子水平低于 134 mEq/L，2686 名（92.6%）的钠离子水平高于 135 mEq/L。钠离子水平低于 134 mEq/L 的患者中，接受紧急降压药的比例更高[165 名（76.7%）与 1811 名（67.4%），p=0.01]、接受产前类固醇的比例更高[103 名（47.9%）与 953 名（35.5%），p=0.001]、以及接受剖宫产的比例更高[27 名（12.6%）与 97 名（3.6%），p<0.001]。我们发现，低钠血症可能与子痫前期伴有严重特征的患者中紧急降压药的使用、产前类固醇的使用和剖宫产有关。需要进一步的研究来确定在伴有严重特征的子痫前期患者中常规评估钠离子水平是否可以识别接受这些治疗的风险患者。
