重度子痫前期患者再次妊娠血压状态及相关危险因素分析  

Analysis of blood pressure status of preeclampsia patients during re-pregnancy and risk factors of severe preeclampsia recurrence

作　　者：李雪芳 侯文杰[2] Li Xuefang;Hou Wenjie(Gynecology and Obstetrics Department,Shaoxing Central Hospital,Shaoxing 312000,China)

机构地区：[1]中国医科大学绍兴医院/绍兴市中心医院妇产科,绍兴312000 [2]苏州大学附属第一医院妇产科,苏州215006

出　　处：《新医学》2020年第12期943-946,共4页Journal of New Medicine

基　　金：江苏省妇幼健康科研项目(F201869)。

摘　　要：目的分析重度子痫前期(sPE)患者再次妊娠的血压状态并分析相关危险因素。方法选择初次妊娠患sPE并再次妊娠的62例孕妇,根据血压等指标分为未再发生sPE组(包括血压正常和轻度子痫前期)和再次发生sPE组,比较2组患者前次妊娠及再次妊娠时的临床特征,采用单因素及多因素Logistic回归分析再次妊娠发生sPE的危险因素。结果单因素分析显示,2组孕妇在前次妊娠发病孕周、前次妊娠终止孕周、再次妊娠年龄、再次妊娠前BMI、是否规律产检和在孕早期(3个月内)服用阿司匹林等方面比较差异均有统计学意义(P均<0.05),而在前次妊娠发生严重产科并发症、前次妊娠胎儿生长受限、2次妊娠间隔时间、补充叶酸、补充钙剂以及是否妊娠期糖尿病等方面组间比较差异均无统计学意义(P均>0.05)。多因素Logistic回归分析显示,再次妊娠年龄≥35岁(OR=9.148)、再次妊娠无规律产检(OR=5.921)和孕早期未予阿司匹林治疗(OR=4.797)均是sPE再次发生的危险因素(P均<0.05)。结论sPE患者再次妊娠时年龄≥35岁,再次发生sPE风险升高,规律产检和在孕早期予阿司匹林治疗可降低sPE再次发生风险。Objective To analyze the blood pressure status of preeclampsia(PE)patients during repregnancy and analyze related risk factors for the recurrence of severe preeclampsia(sPE).Methods Sixtytwo women with a history of sPE during the first pregnancy who were re-pregnant were recruited in this clinical trial.According to the blood pressure level and other parameters,all patients were assigned into the sPE recurrence(normal blood pressure and mild PE)and sPE non-recurrence groups.Clinical characteristics in the first and second pregnancies were compared between two groups.The risk factors of the incidence of sPE during the re-pregnancy were identified by using univariate and multivariate Logistic regression analyses.Results Univariate analysis showed that the gestational week of onset during the first pregnancy,gestational week of pregnancy termination,age of re-pregnancy,body mass index(BMI)before re-pregnancy,regular obstetric examination and use of aspirin during the early trimester(within 3 months)significantly differed between two groups(all P<0.05).However,the incidence of severe obstetric complications and fetal growth restriction(FGR)during the first pregnancy,time interval between two pregnancies,supplement of folic acid and calcium and the incidence of gestational diabetes mellitus(GDM)did not significantly differ between two groups(all P>0.05).Multivariate logistic regression analysis demonstrated that age of re-pregnancy≥35(OR=9.148),iregular obstetric examination(OR=5.921)and not use of aspirin duirng the early trimester(within three months)(OR=4.797)were the risk factors for sPE recurrence(all P<0.05).Conclusions Women with a history of sPE and age≥35 have a higher risk of sPE recurrence.Regular obstetric examination and use of aspirin during the early trimester(within three months)can reduce the risk of sPE recurrence.

关 键 词：重度子痫前期 再次发生 危险因素 

分 类 号：R714.244[医药卫生—妇产科学]