基于深圳市出生队列的妊娠期高血压疾病临床流行病研究  

Clinical epidemiological study of hypertensive disorders of pregnancy based on Shenzhen birth cohort

作　　者：陈艺璇 吴琳琳 刘侃[3] 吴晓霞[4] 牛建民 Chen Yixuan;Wu Linlin;Liu Kan;Wu Xiaoxia;Niu Jianmin(Department of Reproductive Medicine Center,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Obstetrics and Gynecology,the Eighth Affiliated Hospital,Sun Yat-sen University,Shenzhen 518033,China;Department of Obstetrics,Henan Provincial People's Hospital,Zhengzhou 450003,China;Department of Obstetrics,Shenzhen Maternity&Child Healthcare Hospital,Shenzhen 518028,China)

机构地区：[1]河南省人民医院生殖医学中心,郑州450003 [2]中山大学附属第八医院妇产科(深圳福田),深圳518033 [3]河南省人民医院产科,郑州450003 [4]深圳市妇幼保健院产科,深圳518028

出　　处：《中华心血管病杂志》2025年第3期281-286,共6页Chinese Journal of Cardiology

基　　金：国家自然科学基金(72374227);深圳市科技计划(JCYJ20220818103608017,JCYJ20220818103607015)。

摘　　要：目的 探讨中国深圳市妊娠期高血压疾病(HDP)的流行病学现状及趋势。方法 本研究为横断面研究。研究数据基于深圳市出生队列, 纳入2018年1月1日—2023年3月31日完成分娩的孕产妇, 分析HDP及不同病理类型HDP的发病率和变化趋势。根据是否发生HDP将纳入的孕产妇分为HDP组和非HDP组, 收集2组孕产妇的一般临床资料及妊娠结局。统计不同病理类型HDP孕产妇的不良妊娠结局发生情况, 并根据年龄和妊娠早期体重指数(BMI)进行亚组分析。结果 共招募90 117名孕产妇, 年龄(31.6±4.4)岁, HDP组4 117例, 非HDP组86 000人。本研究总体人群中HDP的发病率为4.57%(4 117/90 117)。2018—2023年深圳市HDP发病率呈逐年增长趋势, 从2.88%(523/18 155)增长至7.04%(271/3 851)。其中, 妊娠高血压发病率从0.93%(168/18 155)增长至3.09%(119/3 851), 子痫前期和子痫发病率从1.78%(323/18 155)增长至3.17%(122/3 851), 妊娠合并慢性高血压发病率从0.01%(1/18 155)增长至0.42%(16/3 851), 慢性高血压伴发子痫前期发病率从0.17%(31/18 155)增长至0.36%(14/3 851)。HDP组孕产妇的年龄[(32.8±4.8)岁比(31.5±4.3)岁, P<0.05]和妊娠早期BMI[(23.37±3.77)kg/m^(2)比(21.35±2.91)kg/m^(2), P<0.05]显著高于非HDP组。亚组分析显示, 年龄≥50.0岁孕产妇的HDP发病率在各年龄亚组中最高, 为42.86%(6/14);妊娠早期BMI≥30.0 kg/m^(2)孕产妇的HDP发病率在各BMI亚组中最高, 为20.44%(241/1 179)。HDP组孕产妇发生早产、妊娠期糖尿病、胎儿生长受限、小于胎龄儿、胎盘早剥和晚期流产的比例分别为30.82%(1 269/4 117)、30.46%(1 254/4 117)、6.80%(280/4 117)、4.86%(200/4 117)、3.59%(148/4 117)和0.80%(33/4 117)。结论 中国深圳市孕产妇HDP发病率逐年上升, 且随年龄和妊娠早期BMI的增长, HDP发病率整体呈上升趋势。Objective To investigate the epidemiological characteristics and morbidity trends of hypertensive disorders of pregnancy(HDP)in Shenzhen,China.Methods This study was a cross-sectional study.Data were based on the Shenzhen Birth Cohort.Pregnant women who gave birth from January 1,2018 to March 31,2023 were included.Incidence and change trends of HDP and its different pathological types were analyzed.The enrolled pregnant women were divided into the HDP group and the non-HDP group according to whether HDP occurred.General clinical data and pregnancy outcomes were collected from both groups.The incidence of adverse pregnancy outcomes among pregnant women with different pathological types of HDP was analyzed,and subgroup analyses were performed based on age and body mass index(BMI).Results A total of 90117 pregnant women were enrolled,aged(31.6±4.4)years.There were 4117 cases in the HDP group and 86000 in the non-HDP group.The overallincidence of HDP in the whole study population was 4.57%(4117/90117).From 2018—2023,the incidence of HDP in Shenzhen showed an increasing trend year by year,from 2.88%(523/18155)to 7.04%(271/3851).Specifically,the incidence of gestational hypertension increased from 0.93%(168/18155)to 3.09%(119/3851),the incidence of preeclampsia-eclampsia increased from 1.78%(323/18155)to 3.17%(122/3851),the incidence of chronic hypertension increased from 0.01%(1/18155)to 0.42%(16/3851),and the incidence of chronic hypertension with superimposed preeclampsia increased from 0.17%(31/18155)to 0.36%(14/3851).The age((32.8±4.8)years vs.(31.5±4.3)years,P<0.05)and BMI in the first trimester((23.37±3.77)kg/m^(2)vs.(21.35±2.91)kg/m^(2),P<0.05)of HDP group were higher than those of the non-HDP group.Subgroup analysis showed that the incidence of HDP in pregnant women aged>50.0 years was the highest in all age subgroups(42.86%(6/14)).The incidence of HDP in pregnant women with BMI>30.0 kg/m^(2)in the first trimester was the highest among all BMI subgroups(20.44%(241/1179)).The proportions of preterm birth

关 键 词：高血压 妊娠性 发病率 年龄 体重指数 不良妊娠结局 

分 类 号：R71[医药卫生—妇产科学]