产前期平均动脉压和产后重收治疗与严重特征的孕前之间的关联
Bing-Xue Lin1, Maria Smith2, Megan Sutter3
1Franciscan Women's Health Associates, Tacoma, Washington.
American journal of perinatology
|June 29, 2023
概括
住院期间周周平均动脉压 (MAP) 升高会增加患有严重特征的孕前产后再入院的风险. 监测MAP可以帮助识别需要更密切的产后监测的高风险个体.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 怀孕期间的心血管生理学
背景情况:
- 现有的关于妊娠高血压疾病的研究主要集中在产前管理上.
- 产后孕前的再接收会给母亲的健康带来很大的风险.
- 确定产后并发症的预测因素对于及时干预至关重要.
研究的目的:
- 为了评估围产期平均动脉压 (MAP) 和产后重收治疗与严重特征的孕前之间的关联.
- 确定MAP值是否可以识别处于再接收风险较高的分娩者.
- 探索与再接收风险相关的人口和临床因素.
主要方法:
- 追溯病例控制研究涉及174个再接收病例和174个匹配的对照.
- 在入院,产后24小时和出院时分析MAP.
- 使用多变量逻辑回归和接收器操作特征分析.
- 根据高血压病史进行了子组分析.
主要成果:
- 入院时MAP升高 (aOR:1.37每10mmHg) 和分娩后24小时 (aOR:1.61每10mmHg) 与再入院风险增加有显著关联.
- 非洲裔美国人的种族和妊娠高血压疾病史是独立的危险因素.
- 在入院时MAP>99.5 mmHg或在产后24小时>91.5 mmHg表示至少有46%的再入院风险.
结论:
- 产前期MAP测量,特别是在入院和产后24小时,是产后重入院的有价值预测器,用于具有严重特征的孕前.
- 建立MAP值可以帮助识别那些可能受益于加强产后监测的高风险个体.
- 这些发现表明,MAP监测在改善产后护理对孕前妇女的潜在作用.
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