在怀孕期间检查各种亚型高血压的孕产妇和胎儿的结果
Laith Alhuneafat1, Fares Ghanem2, Sneha Nandy1
1Division of Cardiovascular Disease, University of Minnesota, Minneapolis, MN, USA.
概括
孕期高血压疾病 (HDP),如先兆子和慢性高血压,显著增加孕产妇和胎儿的风险. 孕期高血压本身并没有显示增加不良结果,突出了根据HDP亚型进行量身定制干预的必要性.
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
- 怀孕期间的心血管健康
背景情况:
- 妊娠高血压疾病 (HDP) 是全球主要的孕产妇死亡率和发病率的原因.
- HDP包括多种疾病,包括慢性高血压 (CH),妊娠高血压 (GH),孕前 (PRE) 和叠加孕前 (SPE).
研究的目的:
- 为了在不同类型的HDP和正常压力怀孕中比较医院内母亲和胎儿的结果.
- 为了确定与每个HDP分类相关的特定风险.
主要方法:
- 分析国家住院样本数据集 (2016-2020年),包括超过1900万次分娩入院.
- 将患者分为GH,PRE,SPE,CH和正常压力组.
- 调整了年龄,种族,剖腹产和并发症的回归分析,以比较孕产妇和胎儿的结果.
主要成果:
- 超过270万 (14.5%) 的交付与HDP有关.
- 与正常压力对照组相比,患有PRE,SPE和CH的妇女的死亡率,循环休克,周周心肌病,急性损伤,早产,死产和脑血管事件显著更高.
- 孕产妇死亡率在SPE (aOR 3.16) 中最高,其次是PRE (aOR 2.91) 和CH (aOR 2.42). GH没有显示增加不良结果.
- 所有HDP组都有较高的妊娠年龄较小的出血率和较大的出血率.
结论:
- 慢性高血压,孕前期和叠加孕前期与增加孕产妇和胎儿不良结果有关.
- 妊娠高血压,孤立地,与正常压力怀孕相比,并没有显著增加不良结果.
- 承认HDP亚型之间的分级风险差异对于开发有针对性的干预措施来改善孕产妇和胎儿健康至关重要,特别是对于高风险群体.
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