Uchinuma Hiroyuki, Tsuchiya Kyoichiro, Horiuchi Sayaka, Kushima Megumi, Otawa Sanae, Yokomichi Hiroshi, Miyake Kunio, Akiyama Yuka, Ooka Tadao, Kojima Reiji, Shinohara Ryoji, Yamagata Zentaro
Department of Diabetes and Endocrinology, University of Yamanashi Hospital, Chuo City, Yamanashi, Japan.
Department of Epidemiology and Environmental Medicine, School of Medicine, University of Yamanashi, Chuo City, Yamanashi, Japan.
Hypertens Res. 2025 Mar;48(3):904-913. doi: 10.1038/s41440-024-02019-5. Epub 2024 Nov 29.
Hypertensive disorders of pregnancy (HDP) are leading causes of maternal and infant mortality, and maternal age is a known factor influencing maternal and pediatric outcomes during childbirth. This study aimed to clarify the impact of maternal age-specific blood pressure (BP) and its patterns on the risk of HDP using data from a large nationwide study in Japan. This cohort study (N = 100,949) used data from the Japan Environment and Children's Study. The outcome variables in this study were HDP at each trimester of pregnancy. We stratified the participants into groups according to their age. The risk of HDP tended to be higher in women aged ≥35 years than in those aged <35 years, even at the same BP level. The BP patterns in the first and second trimesters of pregnancy showed a significantly increased risk of developing HDP at a higher BP in the first trimester, even when the BP in the second trimester was the same. The risk of HDP was equivalent in women aged <35 years and those aged≥ 35 years with an approximately 10 mmHg lower BP. In contrast, in women aged ≥35 years, a low diastolic BP in early pregnancy and pulse pressure (PP) > 60 mmHg significantly increased the risk of HDP. This large national cohort study indicates that the risk of HDP is associated with maternal age and PP in Japan. Early diagnosis of HDP can be achieved by focusing on the BP in the first trimester of pregnancy and PP.
妊娠高血压疾病（HDP）是孕产妇和婴儿死亡的主要原因，而产妇年龄是影响分娩期间母婴结局的一个已知因素。本研究旨在利用日本一项大型全国性研究的数据，阐明特定产妇年龄的血压（BP）及其模式对HDP风险的影响。这项队列研究（N = 100,949）使用了日本环境与儿童研究的数据。本研究的结局变量是妊娠各期的HDP。我们根据参与者的年龄将其分为不同组。即使在相同的血压水平下，≥35岁女性患HDP的风险也往往高于<35岁的女性。妊娠第一和第二孕期的血压模式显示，即使第二孕期血压相同，第一孕期血压较高时发生HDP的风险也会显著增加。<35岁的女性和血压约低10 mmHg的≥35岁女性患HDP的风险相当。相比之下，在≥35岁的女性中，妊娠早期舒张压较低和脉压（PP）>60 mmHg会显著增加HDP的风险。这项大型全国性队列研究表明，在日本，HDP的风险与产妇年龄和脉压有关。通过关注妊娠第一孕期的血压和脉压，可以实现HDP的早期诊断。
