妊娠早期血压轻度增高对妊娠期糖尿病的影响  

The effects of mild hypertension in early pregnancy on gestational diabetes mellitus

作　　者：李凤云[1] 瞿龙[2] 李俊林[1] 

机构地区：[1]四川省科学城医院妇产科 [2]四川省科学城医院心内科,绵阳621900

出　　处：《中华高血压杂志》2011年第9期857-860,共4页Chinese Journal of Hypertension

摘　　要：背景妊娠期糖尿病（GDM）围产期并发症较多,且在产后数年内易患包括高血压在内的代谢综合征和产后糖尿病,严重影响围产妇及围产儿的健康,而妊娠早期血压增高是否影响GDM的发病,人们了解甚少。目的探讨妊娠早期血压轻度增高对GDM发病的影响。方法 2007-2010年在四川省科学城医院妇产科产前检查并分娩单胎活产的孕妇1221例。根据妊娠早期血压水平,分为正常血压（血压〈120/80 mm Hg）组[n=605,年龄（28.6±2.8）岁]、正常高值血压[收缩压120-139 mm Hg,和（或）舒张压80~89 mm Hg]组[n=494,年龄（28.3±2.6）岁]及血压轻度增高[收缩压140-149 mm Hg和（或）舒张压90~99 mm Hg]组[n=122,年龄（28.8±2.8）岁]。组间GDM检出率比较用卡方检验和卡方分割法检验,影响GDM事件的因素用Logistic回归分析。结果 GDM 97例（7.9%）。血压轻度增高组、正常高值血压组及正常血压组的GDM检出率分别为24.6%、9.1%及3.6%。卡方检验显示各组GDM总体检出率不等或不全相等,差异有统计学意义（χ2=62.493,P〈0.01）,而卡方分割法检验显示各组GDM总体检出率不等（血压轻度增高组比正常血压组,χ2=67.122;血压轻度增高组比正常高值血压组,χ2=21.928;正常高值血压组比正常血压组,χ2=14.229,均P〈0.01）。Logistic回归分析显示：妊娠早期血压（OR=2.1）、妊娠早期体质量指数（OR=2.6）及孕妇母亲2型糖尿病史（OR=3.5）是妊娠期糖尿病发病的危险因素（χ2=103.298,P〈0.01）。结论妊娠早期血压水平越高,妊娠期糖尿病患病率越高。因此,早期发现并干预妊娠期高血压可能对减少妊娠期糖尿病发病有益。Background Gestational diabetes mellitus（GDM） often results in perinatal complications.Women with GDM are prone to have postpartum diabetes,and metabolic syndrome including hypertension years after delivery.It is unclear if mild hypertension in early pregnancy contributes to GDM.Objective To examine the relationship between blood pressure during early pregnancy and the risk of GDM in a cohort study.Methods One thousand two hundred and twenty-one pregnant patients were selected from a cohort of women delivering one live baby from our department between 2007 and 2010.Patients were categorized according to blood pressure in early pregnancy as normal（less than 120/80 mm Hg） [n=605,the age（28.6±2.8）years],prehypertensive [systolic blood pressure（SBP） from 120 to 139 mm Hg or diastolic blood pressure（DBP） from 80 to 89 mm Hg,n=494,the age（28.3±2.6）years] and mild hypertension [SBP from 140 to 149 mm Hg or DBP from 90 to 99 mm Hg,n=122,the age（28.8±2.8）years] groups.The prevalences of GDM among the groups were compared using chi-square test and partitions of chi-square method.The relationship between blood pressure levels and GDM was evaluated by Logistic regression analyses.Results GDM occurred in 97 patients（prevalence was 7.9%）.The proportions of GDM in mild hypertensive,prehypertensive and normal group were 24.6%,9.1% and 3.6% respectively.There were significant differences in incidences among those groups according to the chi-square test（chi-square value was 62.493,P〈0.01） and partitions of chi-square method（mild hypertensive vs normal,mild hypertensive vs prehypertensive and prehypertensive vs normal,the chi-square values were 67.122,21.928 and 14.229 respectively,all P〈0.01）.When compared to patients with normal blood pressure,women with prehypertension or mild hypertension during early pregnancy had an increased risk of GDM（odds ratio 2.1） using patients Logistic regression analysis（chi-square value was 103.298,P〈0.01）.In addition,pregnant patients with ma

关 键 词：妊娠 高血压 妊娠期糖尿病 

分 类 号：R714.256[医药卫生—妇产科学]