朝の血圧と高リスク妊娠における不良妊娠結果
Ruimin Zhang1, Yiwen Fang1, Yongqiang Ma2,3
1Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
まとめ
母親の朝の血圧 (BP) のモニタリングは,不良な妊娠結果を特定するのに役立ちます. 午前高血圧と夜間または昼間BPの同時発生は,特に妊娠28週から34週間の間,リスクを大幅に増幅します.
科学分野:
- 産婦人科と産婦人科を担当しています.
- 妊娠中の心血管健康について
- 妊産婦・胎児医学について
背景:
- 妊婦の朝の血圧 (BP) と不良妊娠結果 (APO) の関係が完全に理解されていません.
- 高リスク妊娠は,適切な介入のために正確なBPモニタリングを必要とします.
- 既存のBP測定方法は,臨界の時間的なパターンを捕捉できない可能性があります.
研究 の 目的:
- 妊婦の朝の血圧レベルと様々な不良妊娠結果 (APO) の関連性を調査する.
- 伝統的なオフィスBPと比較して,朝のBP測定を組み込む診断の正確さを評価するために.
- 特定のBPの値と,APOリスクの増加に関連するパターンを特定する.
主な方法:
- 高リスクの単発妊娠1833例を対象とした,患者外出のBPモニタリングを用いたレトロスペクティブコホート研究.
- 午前中,非午前中,昼間,夜間,オフィスでのBP測定値の相関分析.
- ロジスティック回帰と感度分析を使用して,朝のBPパターンと複合APOリスクとの関連の評価.
主要な成果:
- 妊婦の26.7%が朝高血圧を発症した.
- 午前中のBPは,非午前中の昼間および夜間のBPと強い相関関係を示したが,オフィスBPと中程度の相関関係を示した.
- 朝のBPを評価に追加することで,さまざまなタイプの高血圧の診断の正確性が向上しました.
- 朝のBPと複合APOリスクの間のJ型関連が特定されました (値≥132/79 mmHg).
- 夜間または朝以外の昼間の高血圧と同時に発生する朝の高血圧は,APOリスクを大幅に増幅しました (ORs 3.16-3.41).
- 最も強いリスク増幅は,妊娠28〜34週間の午前と夜間の高血圧の同時発生で見られた (OR 5.50).
結論:
- 妊婦の朝のBP測定は,妊娠中の高リスクBPパターンのスクリーニングと識別のための貴重なツールです.
- 朝と夜間の高血圧の組み合わせは,特に妊娠の第3四半期に,APOの最も重大なリスクをもたらします.
- 朝の読み込みを含む歩行式BPモニタリングは,妊娠高血圧の管理のために,オフィスBPのみよりも優れた診断精度を提供します.
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