Caritis S, Sibai B, Hauth J, Lindheimer M, VanDorsten P, Klebanoff M, Thom E, Landon M, Paul R, Miodovnik M, Meis P, Thurnau G, Dombrowski M, McNellis D, Roberts J
National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units, Bethesda, Maryland, USA.
Am J Obstet Gynecol. 1998 Oct;179(4):946-51. doi: 10.1016/s0002-9378(98)70194-2.
We assessed several variables as predictors for pre-eclampsia risk in a group of women at high risk.
We studied 2503 women with either diabetes mellitus, chronic hypertension, multifetal gestation, or pre-eclampsia in a previous pregnancy who participated in a multicenter study comparing aspirin and placebo in preventing pre-eclampsia. We evaluated multiple variables for predicting pre-eclampsia risk with use of univariate and multivariable analysis.
Parity and mean arterial pressure at randomization were most predictive of pre-eclampsia risk. The risk was 8% with a mean arterial pressure at enrollment of <75 mm Hg versus 27% with a mean arterial pressure >85 mm Hg (relative risk and 95% confidence interval 3.3 [2.4 to 4.4]). The risk of pre-eclampsia was 26% in nulliparous patients versus 17% in parous subjects (relative risk and 95% confidence interval 1.5 [1.3-1.8]).
The finding that second-trimester mean arterial pressure affects pre-eclampsia risk suggests that the pathophysiologic process of preeclampsia is initiated before that time.
我们评估了多个变量，将其作为一组高危女性子痫前期风险的预测指标。
我们研究了2503名患有糖尿病、慢性高血压、多胎妊娠或既往有子痫前期病史的女性，她们参与了一项比较阿司匹林和安慰剂预防子痫前期的多中心研究。我们采用单变量和多变量分析评估了多个预测子痫前期风险的变量。
产次和随机分组时的平均动脉压对子痫前期风险的预测性最强。入组时平均动脉压<75mmHg者子痫前期风险为8%，而平均动脉压>85mmHg者为27%（相对风险及95%置信区间为3.3[2.4至4.4]）。初产妇子痫前期风险为26%，经产妇为17%（相对风险及95%置信区间为1.5[1.3 - 1.8]）。
孕中期平均动脉压影响子痫前期风险这一发现表明，子痫前期的病理生理过程在此之前就已启动。
