妊娠期高血压前期孕妇母儿转归及其影响因素  

A prospective study on the maternal and fetal outcomes and influencing factors of pre-pregnancy hypertension in pregnant women

作　　者：唐晓彤 陈文梅 吴丹 孙丽洲[1] Tang Xiaotong;Chen Wenmei;Wu Dan(Department of Obstetrics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029;Department of Obstetrics and Gynecology,Nanjing Maternal and Child Health Hospital,Nanjing 210004;Jiangsu Shuyang Maternal and Child Health Hospital,Shuyang 223600)

机构地区：[1]南京医科大学第一附属医院产科,南京210029 [2]南京市妇幼保健院妇产科,南京210004 [3]江苏省沭阳妇幼保健院产科,沭阳223600

出　　处：《现代妇产科进展》2025年第3期191-195,共5页Progress in Obstetrics and Gynecology

基　　金：南京留学人员科技创新(No:147);南京市卫生科技发展专项资金(No:YKK21156)。

摘　　要：目的:探讨妊娠期血压临界孕妇母儿转归情况及其影响因素。方法:收集2022年1月1日至2022年12月31日于南京医科大学第一附属医院及沭阳市妇幼保健院产检的1059例孕妇。根据孕期是否出现临界高血压,将孕妇分为正常血压组(278例)和临界高血压组(781例)。根据是否发展为妊娠期高血压疾病(HDP),将781例临界高血压孕妇分为对照组(618例)和HDP组(163例)。收集并比较孕妇的临床资料及新生儿转归情况。结果:临界高血压组患者的年龄、BMI、孕产次、初产妇比例,以及孕期SBP和DBP均显著高于正常血压组,终止孕周时间早于正常血压组,早产、胎儿生长受限(FGR)、HDP发生率显著升高,新生儿体重低于正常血压组,NICU转诊率显著高于正常血压组,差异有统计学意义(P<0.05)。临界高血压组内未进展为HDP的孕妇口服阿司匹林的孕周显著早于HDP组,且临界高血压发生孕周与HDP呈明显负相关。结论:孕期出现临界高血压的孕妇发生HDP的几率显著增加,且临界高血压出现孕周越早,孕妇在孕中晚期并发HDP的风险显著增高,因此临床医生应重视临界高血压孕妇,适当增加孕早期的产检次数,尽早的诊断治疗HDP,改善临界高血压患者母儿预后。Objective:To explore the maternal and neonatal outcomes of pregnant women with critical blood pressure during pregnancy and their influencing factors.Method:1059 pregnant women who underwent prenatal check ups at the First Affiliated Hospital of Nanjing Medical University and Shuyang Maternal and Child Health Hospital from January 12022 to December 312022 were collected.Pregnant women were divided into a normal group(278 cases)and a critical hypertension group(781 cases)based on whether critical hypertension occurred during pregnancy.781 pregnant women with borderline hypertension were divided into a control group(618 cases)and an HDP group(163 cases)based on whether they developed gestational hypertension(HDP).Collect and compare clinical data of pregnant women and neonatal outcomes.Results:The age,BMI,parity,proportion of primiparous women,as well as SBP and DBP during pregnancy,were significantly higher in the critical hypertension group than those in the normal blood pressure group.The termination of pregnancy was earlier than those in the normal blood pressure group,and the incidence of premature birth,fetal growth restriction(FGR),and HDP was significantly increased.The neonatal body weight was lower than in the normal blood pressure group,and the NICU referral rate was significantly higher than in the normal blood pressure group,with statistical significance(P<0.05).Pregnant women in the critical hypertension group who did not progress to HDP had significantly earlier gestational age with oral aspirin compared to the HDP group,and the gestational age at which critical hypertension occurred was significantly negatively correlated with HDP.Conclusion:Pregnant women with critical hypertension during pregnancy have a significantly increased risk of developing HDP,and the earlier the onset of critical hypertension,the higher the risk of developing HDP in the middle and late stages of pregnancy.Therefore,clinical doctors should pay attention to pregnant women with critical hypertension,appropriately increase the

关 键 词：临界高血压 妊娠期高血压疾病 母儿转归 影响因素 

分 类 号：R714.4[医药卫生—妇产科学]