胎盘附着位置异常对妊娠期高血压-子痫前期发病影响研究  

Potential effects of abnormal placental location on gestational hypertension-preeclampsia

作　　者：董一诺[1] 陆懿[1] 全思洁[1] 应豪[1] 

机构地区：[1]同济大学附属第一妇婴保健院产科,上海200040

出　　处：《中国实用妇科与产科杂志》2014年第12期941-944,共4页Chinese Journal of Practical Gynecology and Obstetrics

基　　金：上海市浦东新区卫生局卫生科技项目(PW2012D-10);上海市卫生局局级重点项目(20124037);上海市级医院新兴前沿技术联合攻关项目(SHDC12012116);上海市自然科学基金(13ZR1432900);上海市科学技术委员会医学引导类(134119a0800);上海市科委产学研医合作项目(13DZ1931002)

摘　　要：目的探讨胎盘附着位置异常对妊娠期高血压-子痫前期发病的影响。方法回顾性分析2010年1月至2012年12月同济大学附属第一妇婴保健院满足入选标准的胎盘附着位置异常的孕妇813例（研究组,其中前置胎盘247例,低置胎盘566例）和胎盘位置正常孕妇813例（对照组）。比较两组孕妇妊娠期高血压-子痫前期、胎盘粘连和胎儿生长受限等发病情况。结果 （1）研究组与对照组妊娠期高血压-子痫前期发生率差异有统计学意义（4.4%vs.8.1%,P〈0.05）;前置胎盘组、低置胎盘组的妊娠期高血压-子痫前期发生率均比对照组低（2.8%vs.8.1%,5.1%vs.8.1%,P〈0.05）;而前置胎盘组妊娠期高血压-子痫前期发生率比低置胎盘组更低（AOR 0.36,95%CI 0.15-0.86）。（2）与对照组相比,低置胎盘能降低妊娠期高血压发病风险（AOR 0.5,95%CI 0.3-0.9）,前置胎盘也能降低妊娠期高血压发病风险（AOR0.27,95%CI 0.09-0.83）。（3）与对照组相比,前置胎盘组子痫前期发生率降低87%（AOR 0.13,95%CI 0.04-0.48）,但低置胎盘组子痫前期发生率并不低于对照组（2.8%vs.3.7%,P〉0.05）;而与低置胎盘组相比,前置胎盘组子痫前期发生率更加低（AOR 0.25,95%CI 0.07-0.89）。（4）胎盘粘连孕妇妊娠期高血压-子痫前期发生率较无胎盘粘连者低（4.1%vs.4.5%,P〉0.05）,但差异无统计学意义。（5）各组之间胎儿生长受限发生率差异无统计学意义。结论胎盘附着位置异常尤其前置胎盘可能会减少妊娠期高血压-子痫前期发生。Objective To discuss whether abnormal placental location influences the incidence of gestational hypertensionpreeclampsia.Methods A retrospective research was performed on the pregnant women with abnormal placental location （study group = 813 cases） and the normal ones （control group = 813 cases） from Jan.2010 to Dec.2012.Compare the incidence of gestational hypertensionpreeclampsia,placental adherence and fetal growth restriction （FGR）between the two groups. Results 1.There was a statistical difference in the incidence of gestational hypertension-preeclampsia between the study group and the control group （4.4% vs.8.1%,P〈0.05）.The incidence of gestational hypertensionreeclampsia of placenta previa was lower than that of low-lying placenta （AOR 0.36,95%CI 0.15-0.86） ,while both of them were entirely lower than that of the control group （2.8% vs.8.1%,5.1% vs.8.1%,P〈0.05）.2.Compared to the control group,the low-lying placenta reduced the risk of gestational hypertension （AOR 0.5,95%CI 0.3-0.9） and so did the placenta previa （AOR 0.27,95%CI 0.09-0.83）.3. Compared to the control group,the placenta previa decreased the risk of preeclampsia by 87% （AOR 0.13,95% CI 0.04-0.48） but the incidence of preeclampsia didnf changed significantly in low-lying placenta （2.8% vs.3.7%,P〉0.05）.The incidence of preeclampsia in the placenta previa was even lower than that in low-lying placenta （AOR 0.25,95%CI 0.07-0.89）.4.Those with placental adherence manifest a lower incidence of gestational hypertension-preeclampsia than those without placental adhesions,but the difference was no statistical significance （4.1% vs.g.5%,P〉0.05）.5.There was no siznificant difference on the incidence of fetal growth restriction.Conclusion Abnormal placental location,especially placenta previa,may decrease the incidence of gestational hypertension- preeclampsia.

关 键 词：前置胎盘 妊娠期高血压-子痫前期 胎儿生长受限 

分 类 号：R714.2[医药卫生—妇产科学]