在状细胞疾病中血压的自然史 怀孕 妊娠
Macy L Early1, Amy Luo2, Marissa Solow3,4
1Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
British journal of haematology
|October 7, 2023
概括
患有状细胞疾病 (SCD) 的孕妇往往比没有SCD的孕妇血压更低. 这可能导致在这个脆弱人群中怀孕高血压障碍 (HDP) 的诊断不足.
科学领域:
- 产科和妇科 产科和妇科
- 血液学 血液学 血液学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 状细胞疾病 (SCD) 显著影响怀孕的结果.
- 妊娠高血压障碍 (HDP) 是患有SCD的孕妇的一个主要问题.
- 了解SCD怀孕中的血压模式对于及时诊断和管理至关重要.
研究的目的:
- 为了比较单独怀孕中SCD与非SCD对照组的血压值和轨迹.
- 在SCD基因型 (HbSS/HbSβ0和HbSC/HbSβ+) 中调查血压和HDP率的潜在差异.
- 探索血压,SCD基因型和HDP发病率之间的关系.
主要方法:
- 在两个学术中心对SCD (1990-2021) 个体的290个单独怀孕的回顾性队列研究.
- 收集的人口统计数据,与SCD相关的数据,怀孕结果,以及连续的静缩和静缩血压 (SBP和DBP) 测量.
- 将SCD队列血压数据与非SCD妊娠控制数据集进行比较.
主要成果:
- 16%的SCD怀孕经历了高血压妊娠障碍 (HDP),基因型没有显著差异.
- 与非SCD对照组相比,HbSS/HbSβ0组的平均SBP和DBP始终较低.
- 在HbSS/HbSβ0怀孕中,血压轨迹与对照体现,而在HbSC/HbSβ+怀孕中,分别在第二和第三季度出现下降和平原.
结论:
- 患有SCD的孕妇通常比非SCD的孕妇血压更低.
- 在SCD怀孕中较低的血压,特别是HbSS/HbSβ0,可能掩盖或导致HDP的低诊断.
- 需要进一步的研究来完善SCD的背景下HDP的诊断标准.
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