妊娠期高血压与不同早产亚型之间的关联性研究  

Relationship Between Gestational Hypertension and Different Subtypes of Preterm Birth/Wang Yang

作　　者：王洋 The First(Obstetrics Department,Obstetrics and Geology Hospital Kaifeng,Kaifeng,Henan,475000,China)

机构地区：[1]开封市妇产医院产一科,河南开封475000

出　　处：《黑龙江医学》2024年第19期2319-2322,共4页Heilongjiang Medical Journal

摘　　要：目的:探讨妊娠期高血压(HDP)与不同早产亚型之间的关联性。方法:选取2020年1月—2022年12月开封市妇产医院行产前检查的孕妇作为研究对象,通过问卷调查、医院电子病历系统等得到所有孕妇基本资料、孕期情况,对所有孕妇进行随访,直至妊娠终止或分娩,记录妊娠结局的相关信息,并构建孕妇队列。利用log-binomial回归模型分析HDP与不同早产亚型之间的关联性;多个混杂因素利用倾向性评分校正法构建模型计算调整后的关联性。结果:2020—2022年早产率比较,差异有统计学意义(χ^(2)=13.764,P<0.05);在13 662例孕妇中,HDP发生率为3.86%,早产发生率为7.91%。1 080例早产中,18例为医源性早产,占1.67%;1 062例为自发性早产,占98.33%,其中,29.17%为早产临产,69.17%为未足月胎膜早破;两组孕妇自发性早产发生率比较,差异有统计学意义(χ^(2)=90.131,P<0.05);两组孕妇未足月胎膜早破发生率比较,差异有统计学意义(χ^(2)=167.813,P<0.05);调整混杂因素后结果显示,HDP孕妇发生未足月胎膜早破的风险是未发生HDP孕妇的1.96倍(aRR=6.495,95%CI:3.774~11.178),HDP与早产临产无关联性。结论:HDP可增加未足月胎膜早破发生风险,与医源性早产、早产临产可能无关。因此医护人员应加强HDP孕妇胎膜检测,关注炎症、羊水量等指标变化,防治胎膜破裂引发早产。Objective:To investigate the relationship between gestational hypertension(HDP)and different preterm birth subtypes.Methods:Pregnant women who underwent prenatal examination in the hospital from January 2020 to December 2022 were selected.The basic information and pregnancy conditions of all pregnant women were obtained through questionnaire survey and hospital electronic medical record system,etc.All pregnant women were followed up until pregnancy termination or delivery,and the relevant information of pregnancy outcome was recorded,and a pregnant women cohort was constructed.Log-binomial regression model was used to analyze the relationship between HDP and different preterm birth subtypes.Multiple confounding factors were modeled with propensity score correction to calculate the adjusted correlations.Results:The preterm birth rate from 2020 to 2022 was statistically significant(χ^(2)=13.764,P<0.05).Among 13662 pregnant women,the incidence of HDP was 3.86%,with 528 cases in HDP group and 13134 cases in non-HDP group.The incidence of preterm birth was 7.91%.Among the 1080 preterm births,18 cases were iatrogenic preterm,accounting for 1.67%,1062 cases were spontaneous preterm,accounting for 98.33%,of which 29.17%were preterm delivery.69.17%were premature rupture of membranes before term.There was significant difference in the incidence of spontaneous prematurity between the two groups(χ^(2)=90.131,P<0.05).There was significant difference in the incidence of premature rupture of membranes between the two groups(χ^(2)=167.813,P<0.05).After adjusting for confounding factors,the risk of preterm premature rupture of membranes in HDP pregnant women was 1.96 times that of those without HDP(aRR=6.495,95%CI:3.774~11.178),and there was no statistical correlation between HDP and preterm delivery.Conclusion:HDP can increase the risk of preterm premature rupture of membranes,and may not be associated with iatrogenic preterm delivery or preterm delivery.Therefore,medical staff should strengthen the detection of fetal membran

关 键 词：妊娠期高血压 自发性早产 早产临产 未足月胎膜早破 医源性早产 

分 类 号：R714.246[医药卫生—妇产科学]