14省、市、自治区妇女妊娠年龄与妊娠期高血压疾病关系的探讨  

Relationship between maternal age and hypertensive disorders in pregnancy

作　　者：刘晓莉[1] 阮炎[1] 刘亚君[1] 张为远[1] 

机构地区：[1]首都医科大学附属北京妇产医院,100026

出　　处：《中华医学杂志》2015年第1期19-22,共4页National Medical Journal of China

基　　金：卫生部公益项目基金（201002013）

摘　　要：目的 了解我国妇女分娩年龄现状及妊娠年龄与妊娠期高血压疾病之间的关系.方法 回顾性调查2011年中国大陆北京、上海、吉林、辽宁、江苏等14个省、市、自治区39家医院妊娠满28周住院分娩的110 450例产妇.按产妇分娩年龄间隔5岁分组,＜15岁的纳入到15 ～ 19岁组,≥45岁的纳入40 ～ 44岁组,共分成6组.以25～ 29岁组的发生风险为1,采用二分类Logistic回归分析计算其他年龄组的相对危险度OR值及95％可信区间.结果 中国妇女平均分娩年龄14～52（28 ±5）岁.妊娠期高血压疾病的发生风险在30岁后呈升高趋势,30～34岁、35～39岁、≥40岁组OR值分别为1.3、2.3及3.3;妊娠合并慢性高血压及妊娠期高血压的发生风险随年龄增长呈升高趋势;子痫前期、重度子痫前期的发生风险在各年龄组呈“U”字型分布,25～29岁组最低,≥40岁组最高（OR值分别为3.6及3.4）;子痫的发生风险,≥40岁组发病率为0,＜20岁组最高（OR值8.7）,20～24岁组次之（OR值2.6）,其他各年龄组与25～29岁组间差异无统计学意义.结论 各种类型妊娠期高血压疾病发生风险在≥35岁高龄妊娠中升高,子痫前期及子痫的发生风险在＜20岁的低龄妊娠中升高.Objective To explore the current status of maternal age and hypertensive disorders in pregnancy related to maternal age in China.Methods The clinical data were collected from 39 hospitals in China's Mainland.All deliveries were performed after 28 weeks of completed gestation between January 1 and December 31,2011.A total of 110 450 cases were enrolled and divided into 6 groups at 5-year intervals according to maternal age.The 25-29 age group was selected as a reference group.The odds ratio （OR） and 95％ confidence interval （CI） were calculated by unadjusted binary-Logistic regression as appropriate.Results The mean age of pregnant women at the time of delivery was 28.18 ± 4.70 （14-52） years.The risk of hypertensive disorders in pregnancy increased in the 3 age groups above 30 years （OR：30-34 age group =1.3,35-39 age group =2.3,≥ 40 age group =3.3）.The risks of chronic hypertension and pregnancy-induced hypertension increased gradually with maternal age.The risks of preeclampsia and severe preeclampsia showed a U-type distribution.The risk was the lowest in the 25-29 age group and the highest in the ≥40 age group （OR =3.6 and 3.4）.The rate of eclampsia was 0 in the ≥40 age group and the highest in the teenage group （OR =8.7）.And it was higher in the 20-24 age group （OR =2.6）.No significant difference existed between other age groups and the 25-29 age group.Conclusion The risk of hypertensive disorders in pregnancy increases gradually with age in pregnant women aged over 35 years.And the risks of preeclampsia and eclampsia rise in teenage pregnancy.Better management helps to reduce the incidence of eclampsia and improve the outcomes of pregnancy in pregnant women with advanced maternal age and teenages.

关 键 词：妊娠期高血压疾病 子痫前期 子痫 妊娠年龄 

分 类 号：R714.246[医药卫生—妇产科学]