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[孕早期孕妇血压与子代先天性心脏病风险之间的关联]

[Association between early pregnancy maternal blood pressure and risk of congenital heart disease in offspring].

作者信息

Zhang E J, Liu R X, Yue W T, Gao S, Su S F, Zhu H P, Liu J H, Xie S H, Zhang Y, Yin C H

机构信息

Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.

Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, Beijing 100026, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2024 Jul 9;104(26):2431-2437. doi: 10.3760/cma.j.cn112137-20231209-01328.

Abstract

To analyze the association between maternal blood pressure and congenital heart disease (CHD) in offspring. From February 2018 to December 2020, pregnant women who participated in the China birth cohort study in Beijing Obstetrics and Gynecology Hospital, Shenzhen Maternal and Child Healthcare Hospital and Chengdu Women's and Children's Central Hospital were enrolled in this study. The baseline and follow-up information were collected using an electronic data collection system. Stepwise logistic regression model was used to analyze the association between maternal blood pressure including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure difference (PP) in the first trimester of pregnancy and the risk of CHD in the offspring. A restrictive cubic spline curve was used to draw the dose-response curve between maternal blood pressure and CHD. A total of 55 552 participants were included in this study. Of them, 31 038, 15 375 and 9 139 pregnant women were enrolled in Beijing Obstetrics and Gynecology Hospital, Shenzhen Maternal & Child Healthcare Hospital and Chendu Women's and Children's Central Hospital, respecitively. The age of pregnant women was (31.3±4.0) and the incidence of CHD in the offspring was 0.78% (435/55 552) Multivariable logistic regression model analysis showed that the increase of SBP (=1.01, 95%: 1.00-1.02), DBP (=1.01, 95%: 1.00-1.03) and MAP (=1.02, 95%: 1.00-1.03) in the first trimester were significantly associated with the risk of CHD in the offspring. The restrictive cubic spline analysis showed a positive linear association of SBP (<0.001; =0.315), DBP (<0.001; =0.928) and MAP (<0.001; =0.929) with the risk of CHD in the offspring. Maternal SBP, DBP and MAP in the first trimester of pregnancy were positively associated with the risk of CHD in the offspring.

摘要

分析母亲血压与子代先天性心脏病(CHD)之间的关联。2018年2月至2020年12月,纳入在北京妇产医院、深圳市妇幼保健院和成都市妇女儿童中心医院参加中国出生队列研究的孕妇。使用电子数据收集系统收集基线和随访信息。采用逐步逻辑回归模型分析妊娠早期母亲血压,包括收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和脉压差(PP)与子代患CHD风险之间的关联。使用限制性立方样条曲线绘制母亲血压与CHD之间的剂量反应曲线。本研究共纳入55552名参与者。其中,分别有31038名、15375名和9139名孕妇在北京妇产医院、深圳市妇幼保健院和成都市妇女儿童中心医院入组。孕妇年龄为(31.3±4.0)岁,子代CHD发病率为0.78%(435/55552)。多变量逻辑回归模型分析显示,妊娠早期SBP(=1.01,95%:1.00 - 1.02)、DBP(=1.01,95%:1.00 - 1.03)和MAP(=1.02,95%:1.00 - 1.03)升高与子代患CHD风险显著相关。限制性立方样条分析显示,SBP(<0.001;=0.315)、DBP(<0.001;=0.928)和MAP(<0.001;=0.929)与子代患CHD风险呈正线性关联。妊娠早期母亲的SBP、DBP和MAP与子代患CHD风险呈正相关。

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