Cincotta R B, Brennecke S P
Department of Perinatal Medicine, Royal Women's Hospital, Melbourne, Australia.
Int J Gynaecol Obstet. 1998 Jan;60(1):23-7. doi: 10.1016/s0020-7292(97)00241-5.
To assess the clinical utility of knowledge of a family history of pre-eclampsia as a predictor for the development of pre-eclampsia in primigravid women.
368 primigravid women were prospectively recruited from the outpatients department of an obstetric teaching hospital. Details of any family history of pre-eclampsia were obtained from the women and their subsequent obstetric outcomes were observed.
Of 368 primigravid women, 34 (9.2%) developed pre-eclampsia. Eighteen (4.9%) women of the total group stated that they had a mother (12), sister (five) or both (one) who had had pre-eclampsia. Of these 18 women, five (27.8%) developed pre-eclampsia. Of the women who had no family history, 29 (8.3%) developed pre-eclampsia (relative risk, RR = 3.4; 95% CI, 1.5-7.6; P = 0.018). Four (22.2%) of the women with a positive family history developed severe pre-eclampsia compared to 18 (5.1%) with a negative family history (RR = 4.3; 95% CI, 1.6-11.5; P = 0.017).
In a primigravida, a family history of pre-eclampsia is associated with a fourfold increased risk of severe pre-eclampsia. This clinical history identifies a group who warrant close clinical surveillance during pregnancy and who may be suitable for trials of prophylactic interventions.
评估子痫前期家族史作为初孕妇女发生子痫前期预测指标的临床效用。
从一家产科教学医院的门诊前瞻性招募368名初孕妇女。获取这些妇女子痫前期家族史的详细信息，并观察她们随后的产科结局。
368名初孕妇女中，34名（9.2%）发生了子痫前期。在整个研究组中，18名（4.9%）妇女表示她们的母亲（12名）、姐妹（5名）或两者（1名）曾患子痫前期。在这18名妇女中，5名（27.8%）发生了子痫前期。在无家族史的妇女中，29名（8.3%）发生了子痫前期（相对危险度，RR = 3.4；95%可信区间，1.5 - 7.6；P = 0.018）。家族史阳性的妇女中有4名（22.2%）发生了重度子痫前期，而家族史阴性的妇女中有18名（5.1%）发生了重度子痫前期（RR = 4.3；95%可信区间，1.6 - 11.5；P = 0.017）。
在初孕妇中，子痫前期家族史与重度子痫前期风险增加四倍相关。这一临床病史可识别出一组在孕期需要密切临床监测且可能适合预防性干预试验的人群。
