Ananth C V, Peedicayil A, Savitz D A
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599, USA.
Epidemiology. 1995 Jul;6(4):391-5. doi: 10.1097/00001648-199507000-00011.
We measured the impact of hypertensive disorders in pregnancy (chronic hypertension, pregnancy-induced hypertension, and eclampsia) on birthweight, gestational duration, and small-for-gestational-age births. We employed a retrospective cohort design using North Carolina birth certificate data for the years 1988-1990, with the analyses based on nearly 300,000 pregnancies. Women noted to have eclampsia during pregnancy had a substantially greater risk of delivering very-low-birthweight infants (birthweight < or = 1,499 gm; risk difference (RD) = 6.7%) and moderately-low-birthweight infants (1,500-2,499 gm; RD = 14.6%), and very preterm (gestational age < 33 weeks; RD = 7.1%) and moderately preterm (33-36 weeks; RD = 9.3%) births, compared with women without hypertension. Corresponding risk differences for these outcomes were 1.9% and 5.1% for very low and moderately low birthweight, and 1.6% and 3.0% for very preterm and moderately preterm for women with chronic hypertension. Risk differences were of similar magnitude for women with pregnancy-induced hypertension for these outcomes. Hypertensive disorders in pregnancy were associated with small-for-gestational-age infants, with risk differences of 5.1%, 3.5%, and 9.2% for chronic hypertension, pregnancy-induced hypertension, and eclampsia, respectively. The patterns of risk were similar for preterm births due to spontaneous onset of labor and those due to other precipitating events. We observed similar patterns for black and white women. Control for confounders through multivariable logistic regression models did not alter the observed patterns. In spite of the limited data quality, we found that hypertensive disorders in pregnancy substantially increase the risk of low birthweight, preterm births, and small-for-gestational-age births.
我们测量了妊娠期高血压疾病（慢性高血压、妊娠期高血压和子痫）对出生体重、孕周以及小于胎龄儿出生情况的影响。我们采用回顾性队列设计，利用北卡罗来纳州1988 - 1990年的出生证明数据，分析基于近30万例妊娠。与无高血压的女性相比，孕期出现子痫的女性分娩极低出生体重儿（出生体重≤1499克；风险差异（RD）= 6.7%）、中度低出生体重儿（1500 - 2499克；RD = 14.6%）、极早产（孕周< 33周；RD = 7.1%）和中度早产（33 - 36周；RD = 9.3%）的风险显著更高。慢性高血压女性出现这些结局的相应风险差异，极低和中度低出生体重分别为1.9%和5.1%，极早产和中度早产分别为1.6%和3.0%。妊娠期高血压女性出现这些结局的风险差异幅度相似。妊娠期高血压疾病与小于胎龄儿有关，慢性高血压、妊娠期高血压和子痫导致小于胎龄儿的风险差异分别为5.1%、3.5%和9.2%。因自然发动分娩和其他促发事件导致的早产风险模式相似。我们在黑人女性和白人女性中观察到相似模式。通过多变量逻辑回归模型控制混杂因素并未改变观察到的模式。尽管数据质量有限，但我们发现妊娠期高血压疾病会大幅增加低出生体重、早产和小于胎龄儿出生的风险。
