孕期高血压,孕前和孕后以及未来的神经疾病
Therese Friis1, Lina Bergman1,2,3,4, Susanne Hesselman1
1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
JAMA neurology
|December 23, 2024
概括
妊娠并发症,如妊娠高血压,妊娠前和妊娠后,在分娩后的几年增加了新的神经系统疾病的风险,包括偏头痛,和睡眠问题. 医疗保健提供者应在产后随访期间监测患有这些疾病的妇女是否有神经症状.
科学领域:
- 神经学 神经学
- 产科 产科 产科 产科 产科
- 公共卫生 公共卫生
背景情况:
- 孕期高血压,孕前和孕后是已知的长期神经疾病 (如中风和痴呆症) 的风险因素.
- 这些妊娠并发症与分娩后的几个月到几年的新神经疾病发展风险之间的关联仍然不清楚.
研究的目的:
- 调查妊娠高血压,孕产妇前和孕产妇之间的关系以及新发的神经疾病的风险.
- 确定这些妊娠并发症是否与偏头痛,头痛,,睡眠障碍或分娩后精神疲劳等疾病有关.
主要方法:
- 一项基于注册的队列研究,使用瑞典国家注册表从2005年到2019年.
- 包括648,385名初产妇妇女,随访时间从分娩后42天开始.
- 使用考克斯回归分析进行风险评估,计算 95% 置信区间 (CI) 的调整危险比率 (aHR).
主要成果:
- 孕期高血压,孕前和孕后显著与新发的神经疾病风险增加有关.
- 具体发现包括妊娠高血压的aHR为1.27,妊娠前的1.32和妊娠后的1.70.
- 患有黄昏症的女性患的风险增加了5倍以上 (aHR,5.31).
结论:
- 妊娠高血压,妊娠前和妊娠后与分娩后发展新神经疾病的风险更高有关.
- 目前的指导方针建议这些妇女进行产后心血管疾病查.
- 医疗保健提供者还应该评估新的或持续的神经症状,认识到这个患者群体的脆弱性.
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