Wang Runfang, Du LiYan, Di Jiaoyang, Duan Ya, Lian Wenning, Liu Li, Liu Suxin, Yang Dandan, Huo Yan
Department of Obstetrics and Gynecology, Hebei General Hospital, Hebei, 050057, China.
Department of Information Management, Hebei Center for Women and Children's Health, Hebei, 050000, China.
BMC Pregnancy Childbirth. 2025 May 3;25(1):528. doi: 10.1186/s12884-025-07609-w.
This study aimed to assess the incidence, trends, and adverse pregnancy outcomes associated with preeclampsia (PE), while further investigating whether these adverse outcomes differ by parity and the type of pregnancy-twin or singleton.
A multicenter cross-sectional study was conducted in Hebei, China, spanning the years 2013 to 2022, enrolling a total of 455,456 women. The incidence rates and trends of PE and its subtypes were analyzed utilizing joinpoint regression analysis, while modified Poisson regression was employed to assess the association between PE and adverse pregnancy outcomes. Effect modification by parity, twin or singleton pregnancy was also evaluated.
The prevalence of PE and its stratification by singleton pregnancies and parity (primiparas versus multiparas) exhibited upward trends, with no statistically significant changes observed in the incidence of twins affected by PE from 2013 to 2022 in Hebei Province. After adjusting for sociodemographic characteristics and other comorbidities during pregnancy, patients with PE experienced significantly elevated risks of cesarean section (adjusted relative risk [aRR], 4.78; 95% confidence interval [CI], 4.54-5.02), postpartum hemorrhage (aRR, 1.97; 95% CI, 1.75-2.21), placental abruption (aRR, 1.52; 95% CI, 1.37-1.69), preterm birth (aRR, 5.35; 95% CI, 5.14-5.56), small for gestational age (SGA) newborns (aRR, 2.48; 95%CI, 2.38-2.58), maternal near-miss events (MNM) (aRR, 1.18; 95% CI, 1.01-1.38), and admission to the neonatal intensive care unit (NICU) (aRR, 1.27; 95% CI, 1.11-1.44). In contrast, the risk of placenta previa was significantly lower (aRR, 0.26; 95% CI, 0.21-0.32). The risks of cesarean section, postpartum hemorrhage, and preterm birth ascribable to PE were conspicuously augmented in twin pregnancies; conversely, the risk of placental abruption was more notable in singletons. The influence on cesarean delivery was pronounced in primiparas, while the risks of MNM, placental abruption, and preterm birth related to PE escalated in multiparas.
The incidences of PE in overall, singletons, primiparas and multiparas exhibited upward trends in Hebei from 2013 to 2022. Women afflicted with PE demonstrated a conspicuously augmented risk of adverse pregnancy outcomes and the magnitude of the influence of PE varied with singleton or twin pregnancies and parity.
本研究旨在评估子痫前期（PE）的发病率、趋势及相关不良妊娠结局，同时进一步探究这些不良结局在不同胎次以及双胎或单胎妊娠类型中是否存在差异。
2013年至2022年在中国河北省开展了一项多中心横断面研究，共纳入455,456名女性。利用Joinpoint回归分析方法分析PE及其亚型的发病率和趋势，采用修正泊松回归评估PE与不良妊娠结局之间的关联。同时评估胎次、双胎或单胎妊娠的效应修饰作用。
PE的患病率及其在单胎妊娠和胎次（初产妇与经产妇）中的分层呈上升趋势，2013年至2022年河北省双胎受PE影响的发病率未观察到统计学显著变化。在调整社会人口学特征和孕期其他合并症后，PE患者剖宫产（调整后相对风险[aRR]，4.78；95%置信区间[CI]，4.54 - 5.02）、产后出血（aRR，1.97；95%CI，1.75 - 2.21）、胎盘早剥（aRR，1.52；95%CI，1.37 - 1.69）、早产（aRR，5.35；95%CI，5.14 - 5.56）、小于胎龄（SGA）新生儿（aRR，2.48；95%CI，2.38 - 2.58）、孕产妇严重并发症（MNM）（aRR，1.18；95%CI，1.01 - 1.38）以及入住新生儿重症监护病房（NICU）（aRR，1.27；95%CI，1.11 - 1.44）的风险显著升高。相比之下，前置胎盘的风险显著降低（aRR，0.26；95%CI，0.21 - 0.32）。双胎妊娠中因PE导致的剖宫产、产后出血和早产风险显著增加；相反，单胎妊娠中胎盘早剥的风险更显著。剖宫产的影响在初产妇中较为明显，而与PE相关的MNM、胎盘早剥和早产风险在经产妇中升高。
2013年至2022年河北省总体、单胎、初产妇和经产妇中PE的发病率呈上升趋势。患有PE的女性不良妊娠结局风险显著增加，且PE的影响程度因单胎或双胎妊娠以及胎次而异。
