产妇胎盘综合征 (CHAMPS) 后的心血管健康:基于人口的回顾性队列研究
Joel G Ray1, Marian J Vermeulen, Michael J Schull
1Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario M5B 1W8, Canada. rayj@smh.toronto.on.ca
Lancet (London, England)
|November 22, 2005
概括
经历母亲胎盘综合征的女性面临着早发心血管疾病的两倍风险. 这种风险在与胎儿生长问题或子宫内胎儿死亡相结合时显著放大,突出显示出需要产后监测.
科学领域:
- 产科和妇科 产科和妇科
- 心血管医学 心血管医学
- 流行病学 流行病学
背景情况:
- 母胎盘综合征 (MPS) 与胎盘血管疾病有关,并且经常发生在患有心血管疾病风险因素的女性中.
- 肥胖,高血压,糖尿病和脂质失调等代谢风险因素在患有MPS的女性中很常见.
- 这项研究旨在评估MPS与晚年发展过早血管疾病的风险之间的关联.
研究的目的:
- 评估有母亲胎盘综合征史的妇女早发心血管疾病 (CVD) 的风险.
- 调查胎儿妥协,如胎儿生长不良或子宫内胎儿死亡,是否会改变这种风险.
主要方法:
- 一项以人口为基础的回顾性队列研究在加拿大安大略省进行,涉及超过100万名女性.
- 孕产妇的胎盘综合征被定义为子宫前,妊娠高血压,胎盘断裂或胎盘发作.
- 心血管疾病是主要终点,定义为冠状动脉,脑血管或外周动脉疾病的住院或再血管化.
主要成果:
- 7%的妇女 (75,380) 被诊断出患有母亲胎盘综合征.
- 患有MPS的女性心血管疾病发病率增加了2倍 (每百万人年500对200).
- 同时胎儿生长不良 (HR 3.1) 或子宫内胎儿死亡 (HR 4.4) 时,心血管疾病的风险显著增加.
结论:
- 孕产妇的胎盘综合征显著增加了早发心血管疾病的风险,特别是当胎儿存在妥协时.
- 在分娩后6个月左右,建议对受影响的妇女进行产后血压和体重的监测.
- 强调采用健康的生活方式对于有MPS病史的女性来说至关重要,以减轻心血管风险.
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