2012年至2021年期间中国杭州妊娠期高血压疾病的发病率及影响因素
The incidence and influencing factors of hypertensive disorders during pregnancy in hangzhou, China, between 2012 and 2021.
作者信息
Chen Yiming, Wu Bin, Zhang Huimin, Chu Xuelian, Huang Lingling, Wang Yanan, Liang Xiufeng
机构信息
Prenatal Diagnosis and Screening Center, Hangzhou Women's Hospital (Hangzhou Maternity and Child Health Care Hospital), Hangzhou, Zhejiang, 310008, China.
The Fourth School of Clinical Medical, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, 310053, China.
出版信息
Heliyon. 2025 Jan 8;11(4):e41680. doi: 10.1016/j.heliyon.2025.e41680. eCollection 2025 Feb 28.
OBJECTIVE
To analyze the incidence and influencing factors of hypertensive disorders of pregnancy (HDP) in Hangzhou, China, between 2012 and 2021.
METHODS
We conducted a retrospective cohort study to analyze data relating to 155,433 pregnant women in Hangzhou, China, who were divided into eight groups: gestational hypertension (GH, 4247 cases), preeclampsia (PE, 1602 cases), severe preeclampsia (SPE, 995 cases), eclampsia (9 cases), HELLP syndrome (43 cases), chronic hypertension (43 cases), chronic hypertension combined with PE or SPE (77 cases), postpartum eclampsia (5 cases), and pregnant women with normal blood pressure (148412 cases). Odds ratios (ORs) and 95 % confidence intervals (95 % CIs) were used to show the association of factors with HDP.
RESULTS
The total incidence of HDP was 45.17 ‰ (95 % CI: 44.14‰-46.20 ‰), and the subtypes of HDP showed an increasing trend from 2012 to 2021 (all < 0.01). Several maternal characteristics, including maternal age (OR = 1.158 (1.035-1.295), 1.697 (1.478-1.948), and 2.769 (2.234-3.433), OR = 1.526 (1.224-1.902) to 2.506 (1.796-3.497)), non-local residence (OR = 1.124 (1.018-1.241), 1.212 (1.032-1.423), and 1.222 (1.010-1.479)), fertilization (OR = 1.263 (1.028-1.551), 1.342 (1.042-1.729) and 1.692 (1.234-2.321)), graviditas ≤1 (OR = 1.126 (1.035-1.226)), parity <1 (OR = 1.140 (1.026-1.265), OR = 1.336 (1.130-1.581)), non-vaginal delivery (OR = 1.525 (1.223-1.901), 1.185 (1.058-1.328) an 1.753 (1.612-1.908); OR = 2.108 (1.428-3.112), 1.464 (1.174-1.826) and 4.205 (3.643-4.854), and OR = 7.000 (3.517-13.930), 1.914 (1.217-3.010) and 19.981 (14.936-26.730)), maternal hospitalization >7 days (OR = 2.098 (1.921-2.291), 2.115 (1.857-2.409), and 1.553 (1.333-1.810)), and winter birth (OR = 1.297 (1.196-1.408), OR = 1.425 (1.242-1.636)), were all identified as risk factors for GH, PE, and SPE. Furthermore, HDP may increase the risk of gestational period <37 weeks, low birth weight (LBW), fetal macrosomia, and a birth length <50 cm (all < 0.05).
CONCLUSIONS
The incidence of HDP and its subtypes showed an overall increasing trend from 2012 to 2021. Maternal factors and pregnancy outcomes may be strongly associated with HDP.
目的
分析2012年至2021年中国杭州妊娠期高血压疾病（HDP）的发病率及其影响因素。
方法
我们进行了一项回顾性队列研究，分析了中国杭州155,433名孕妇的数据，这些孕妇被分为八组：妊娠期高血压（GH，4247例）、子痫前期（PE，1602例）、重度子痫前期（SPE，995例）、子痫（9例）、HELLP综合征（43例）、慢性高血压（43例）、慢性高血压合并PE或SPE（77例）、产后子痫（5例）以及血压正常的孕妇（148412例）。采用比值比（OR）和95%置信区间（95%CI）来显示各因素与HDP的关联。
结果
HDP的总发病率为45.17‰（95%CI：44.14‰ - 46.20‰），HDP的各亚型在2012年至2021年呈上升趋势（均P < 0.01）。一些孕产妇特征，包括产妇年龄（OR = 1.158（1.035 - 1.295）、1.697（1.478 - 1.948）和2.769（2.234 - 3.433），OR = 1.526（1.224 - 1.902）至2.506（1.796 - 3.497））、非本地居住（OR = 1.124（1.018 - 1.241）、1.212（1.032 - 1.423）和1.222（1.010 - 1.479））、受孕方式（OR = 1.263（1.028 - 1.551）、1.342（1.042 - 1.729）和1.692（1.234 - 2.321））、妊娠次数≤1（OR = 1.126（1.035 - 1.226））、产次<1（OR = 1.140（1.026 - 1.265）、OR = 1.336（1.130 - 1.581））、非阴道分娩（OR = 1.525（1.223 - 1.901）、1.185（1.058 - 1.328）和1.753（1.612 - 1.908）；OR = 2.108（1.428 - 3.112）、1.464（1.174 - 1.826）和4.205（3.643 - 〈4.854〉），以及OR = 7.000（3.517 - 13.930）、1.914（1.217 - 3.010）和19.981（14.936 - 26.730））、产妇住院>7天（OR = 2.098（1.921 - 2.291）、2.115（1.857 - 2.409）和1.553（1.333 - 1.810））以及冬季出生（OR = 1.297（1.196 - 1.408）、OR = 1.425（1.242 - 1.636）），均被确定为GH、PE和SPE的危险因素。此外，HDP可能增加孕周<37周、低出生体重（LBW）、巨大儿和出生身长<50 cm的风险（均P < 0.05）。
结论
2012年至2021年HDP及其亚型的发病率总体呈上升趋势。孕产妇因素和妊娠结局可能与HDP密切相关。
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