Jain Shuchi M, Deshmukh Pradeep, Mor Shreya Sharad, Shivkumar Poonam Varma, Tembhare Amardeep
Department of Obstetrics and Gynecology, Mahatama Gandhi Institute of Medical Sciences, SevagramWardha, Maharashtra India.
Department of Community Medicine, AIIMS, Nagpur, Maharashtra India.
J Obstet Gynaecol India. 2025 Apr;75(2):148-154. doi: 10.1007/s13224-024-02027-y. Epub 2024 Jul 16.
This prospective cohort study was planned to elucidate the magnitude and epidemiological determinants for hypertensive disease in pregnancy (HDP) in a cohort of rural women of central India.
It was a community-based prospective cohort study of rural pregnant women. 1650 eligible women were recruited at less than 20 weeks of gestation by pretrained field workers in 100 villages of Wardha District. Baseline socio-demographic factors of all subjects were recorded with the help of open-ended pre-designed and tested questionnaire. They were screened for high risk factors. The woman was followed up till delivery for development of hypertensive disorder of pregnancy.
The overall incidence of hypertensive disorders in pregnancy was 7.15%. On univariate analysis, significant determinants of HDP were education, occupation, socio-economic status, interval from previous pregnancy, BMI, calcium intake, stress, and family history of hypertension. Odds of HDP increased by 1.075 times with every additional year of age (95%CI: 1.001 to 1.154), by 1.165 times if BMI increases by one unit (95%CI: 1.165 to 1.168), by 1.168 times if stress score increases by one (95%CI: 1.091 to 1.252), and reduced by 0.736 if haemoglobin increases by one gm/dl (95%CI: 0.632 to 0.858). Family history of hypertension doubles the odds of HDP (95%CI: 1.075 to 3.813).
This study helped us to know the burden and various epidemiological determinants of hypertensive disorders. It helped us in identifying the modifiable high risk factors that stakeholders should give due attention to formulate preventive strategies for improving obstetric outcome.
The online version contains supplementary material available at 10.1007/s13224-024-02027-y.
本前瞻性队列研究旨在阐明印度中部农村女性队列中妊娠期高血压疾病(HDP)的严重程度和流行病学决定因素。
这是一项基于社区的农村孕妇前瞻性队列研究。在沃德哈区的100个村庄中,由经过预培训的现场工作人员在妊娠20周前招募了1650名符合条件的女性。借助开放式预先设计和测试的问卷记录了所有受试者的基线社会人口学因素。对她们进行了高危因素筛查。对这些女性进行随访直至分娩,以观察妊娠期高血压疾病的发生情况。
妊娠期高血压疾病的总体发病率为7.15%。单因素分析显示,HDP的重要决定因素包括教育程度、职业、社会经济地位、距上次妊娠的间隔时间、体重指数(BMI)、钙摄入量、压力以及高血压家族史。年龄每增加一岁,HDP的发病几率增加1.075倍(95%置信区间:1.001至1.154);BMI每增加一个单位,发病几率增加1.165倍(95%置信区间:1.165至1.168);压力评分每增加一分,发病几率增加1.168倍(95%置信区间:1.091至1.252);血红蛋白每增加1克/分升,发病几率降低0.736(95%置信区间:0.632至0.858)。高血压家族史使HDP的发病几率增加一倍(95%置信区间:1.075至3.813)。
本研究有助于我们了解高血压疾病的负担和各种流行病学决定因素。它有助于我们识别可改变的高危因素,利益相关者应予以充分关注,以制定预防策略,改善产科结局。
在线版本包含可在10.1007/s13224-024-02027-y获取的补充材料。