妊娠期高血压疾病发病规律及高危因素分析  

Analysis on occurrence regularity of hypertensive disorder complicating pregnancy and high risk factors

作　　者：黄淑晖[1] 刘淮[1] 刘勍[1] 程海燕[1] 倪金莲[1] 

机构地区：[1]江西省妇幼保健院产科,330006

出　　处：《中国妇幼保健》2013年第15期2354-2357,共4页Maternal and Child Health Care of China

基　　金：国家支撑计划项目〔2008BAI68B0〕

摘　　要：目的:探讨妊娠期高血压疾病(HDCP)严重并发症相关高危因素。方法:对住院分娩诊断为HDCP孕妇年龄、孕、产次、双(多)胎、地区、是否系统产检、高血压病史和妊娠期高血压病史及家族史、HDCP及其严重并发症发病情况、围生儿情况进行调查分析HDCP发病的一般规律、城市/乡村发病的差别以及导致孕产妇及围生儿严重并发症的高危因素。结果:住院孕妇总数为24 154例,其中HDCP患者921例,发生率为3.81%。妊娠高血压、子痫前期、子痫、慢性高血压并子痫前期、妊娠合并慢性高血压分别占HDCP的29.97%、64.60%、2.39%、2.39%、0.65%,产后出血及胎儿宫内生长受限分别占HDCP的50.00%、44.00%。HDCP患者中城市505例,农村416例,合并严重并发症城市10例,农村36例;围产儿不良结局(包括FGR、死胎、新生儿死亡、流产、新生儿窒息等)城市82例,农村129例,将孕妇年龄分为17～20、21～25、26～30、31～35、36～40和≥41岁年龄段,其HDCP发生率分别为6.73%、28.23%、28.66%、21.82%、11.62%、2.93%;在17～20岁年龄段围产儿不良结局发生率比其他年龄段显著增高(P<0.05),孕妇合并严重并发症在各年龄段间差异无统计学意义(P>0.05)。Logistic逐步回归分析低龄、双胎(多胎)、农村地区、文化程度及无系统产检均为HDCP孕妇严重并发症及围生儿不良结局的高危因素。结论:产后出血、早产及胎儿宫内生长受限仍是江西省HDCP孕妇和围生儿最主要的并发症。年龄、农村人口、文化程度≤初中、无系统产检是HDCP孕妇严重并发症及围生儿不良结局的高危因素。Objective： To explore the related high risk factors of hypertensive disorder complicating pregnancy （HDCP） . Meth- ods .. The data of pregnant women who were diagnosed as hypertensive disorder complicating pregnancy （HDCP） were Collected and investi- gated, then they gave birth to their babies in the hospital from July 1, 2008 to June 30, 2010. The data collected included age, times of pregnaney, double （multiple） pregnancy, the urban - rural structure, systematieness of prenatal examination, histories of hypertension, hy- pertensive disorder complicating pregnancy （HDCP）, and farnily medical history, situations of HDCP, serious complications of HDCP, and perinatal situation. The general occurrence regularity of HDCP, the incidence differences between cities and countries and the high risk fac- tors ofSerious＇complications Of maternal and perinatal child were analyzed. Results ： From July 1, 2008 to June 30, 2010, the total number of hospitalized pregnant women in the hospital was 24 154 . Ninety -two patients were found with HDCP. The incidence rate was 3.81% , the constituent ratios of preeclampsia, eclampsia, chronic hypertension merged preeelampsia, pregnancy combined with chronic hypertension a- mong HDCP patients were 29. 97%, 64. 60%, 2. 39%, 2. 39%, and 0. 65%, respectively. And the incidence rates of postpartum hemor- rhage and fetal growth restriction were 50% and 44% , respectively. Among these 921 HDCP women, there were 505 urban cases and 416 rural eases. Ten HDCP women with serious complications were from cities, the rate was 1.09%. Thirty -six cases were from rual areas, the rate was 3.91%. Eighty -two cases were found with perinatal adverse outeomes, including fetal growth restriction, stillbirth, neonatal death, abortion, neonatal asphyxia, accounting for 8. 90% , 129 cases were from rural areas ,. accounting for 14.00% ; puting maternal age into six fractions as below： 17 -20 21 -25 26 -30, 31 -35, 36 -40, and 〉40 years, the HDCP~ incidence rates.were 6.73% 28. 23% , 28

关 键 词：妊娠期高血压疾病 流行病学 高危因素 

分 类 号：R714.246[医药卫生—妇产科学]