不同分期慢性肾脏疾病女性妊娠结局及预后的危险因素分析  

The Risk Factors of Pregnancy Outcomes and Prognosis in Women Complicated with Different Chronic Kidney Disease Stages

作　　者：刘婧[1,2] 赫英东 陈倩[1] LIU Jing;HE Yingdong;CHEN Qian(Department of Obstetrics and Gynecology,Peking University First Hospital,Beijing 100034,China;Department of Obstetrics,Haidian Maternal and Child Health Hospital,Beijing 100080,China)

机构地区：[1]北京大学第一医院妇产科,北京100034 [2]北京市海淀区妇幼保健院产科,北京100080

出　　处：《实用妇产科杂志》2020年第10期769-772,共4页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探讨妊娠与慢性肾脏疾病(CKD)的相互影响,分析不同分期CKD孕妇的妊娠结局及预后的危险因素。方法:回顾性分析2004年1月至2015年12月在北京大学第一医院妇产科进行产前保健、资料完整且合并CKD孕妇(共267例)的临床资料,分析不同分期CKD孕妇的临床资料及妊娠结局。对入组CKD孕妇进行产后随访,分析不同分期CKD孕妇的妊娠结局差异及预后的危险因素。结果:①与CKD 1期比较,CKD 3期和4期孕妇的早产和低出生体质量儿发生率明显升高(P<0.05)。②妊娠早期CKD分期越高,产后肾功能恶化风险越大(CKD 2期HR=5.918,P=0.009;CKD 3和4期HR=8.336,P=0.008)。③妊娠早期尿蛋白定量≥1 g(HR=5.248,P=0.006)是CKD女性产后新发高血压的危险因素。结论:①晚期CKD孕妇的早产率及低出生体质量儿发生率较CKD 1期升高。②妊娠早期CKD分期越高,产后肾功能恶化风险越大;妊娠早期尿蛋白定量对CKD孕妇产后新发高血压有重要影响。Objective:To study the interactions between pregnancy and chronic kidney disease(CKD),and to investigate the risk factors of pregnancy outcomes and prognosis in women complicated with CKD.Methods:The clinical data and pregnancy outcomes of 267 women complicated with different stages of CKD who received prenatal care between January,2004 and December,2015 in Peking University First Hospital were retrospectively analyzed.Postpartum follow-up was carried out for women with CKD.The risk factors of pregnancy outcomes and prognosis were analyzed in women with different stages of CKD.Results:①Compared with CKD 1 stage,the incidence of preterm labor and low birth weight infants increased significantly in CKD 3 stage and CKD 4 stage(P<0.05).②The higher the CKD stages in early pregnancy,the higher the risk of renal function decline after delivery(in CKD 2 stage HR=5.918,P=0.009,in CKD 3 and 4 stage HR=8.336,P=0.008).③Urinary protein content≥1 g in early pregnancy(HR=5.248,P=0.006)was the risk factor for new onset hypertension after delivery in womem with CKD.Conclusions:①The risk of preterm labor and low birth weight infants increase in advanced CKD stages compared with those in CKD 1.②The higher the CKD stages in early pregnancy,the higher the risk of renal function decline after delivery.The urinary protein content has effects on the new onset hypertension after delivery in women with CKD.

关 键 词：妊娠 慢性肾脏疾病 妊娠早期指标 妊娠结局 产后随访 

分 类 号：R714.254[医药卫生—妇产科学]