怀孕期间轻度慢性高血压患者的脉压和不良孕产妇和产周结局
Samantha L Martin1, Justin M Leach1, Rachel Sinkey1
1Department of Obstetrics and Gynecology, the Center for Women's Reproductive Health, and the Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama; the Department of Obstetrics and Gynecology, University of North Carolina Chapel Hill, Chapel Hill, and the Department of Obstetrics and Gynecology, Duke University, Durham, North Carolina; the Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, the Department of Obstetrics and Gynecology, St. Luke's University Health Network, Bethlehem, the Department of Obstetrics and Gynecology, Drexel University College of Medicine, Philadelphia, and the Department of Obstetrics and Gynecology, Lehigh Valley Health Network, Allentown, Pennsylvania; the Department of Obstetrics and Gynecology, University of Texas at Houston, and the Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, and the Department of Obstetrics and Gynecology, University of Texas Medical Branch, Galveston, Texas; HCA Healthcare and HCA Research Institute, Nashville, Tennessee; Maternal Fetal Care Center, Division of Fetal Medicine & Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts; the Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; the Department of Obstetrics and Gynecology, MetroHealth/Case Western University, Cleveland, the Department of Obstetrics and Gynecology, The Ohio State University, Columbus, and the Division of Maternal-Fetal Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; the Department of Obstetrics and Gynecology, Indiana University, Indianapolis, Indiana; the Department of Obstetrics and Gynecology, University of Utah Health, Salt Lake City, Utah; the Department of Obstetrics and Gynecology, Ochsner Health, and the Department of Obstetrics & Gynecology, Tulane University, New Orleans, Louisiana; the Department of Obstetrics and Gynecology, University of Wisconsin-Madison, and the Department of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, Wisconsin; the Department of Obstetrics and Gynecology, Washington University in St. Louis, St. Louis, Missouri; the Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, Mississippi; the Department of Obstetrics and Gynecology, Robert Wood Johnson Medical School, Rutgers University, Brunswick, and the Department of Obstetrics, Gynecology and Reproductive Health, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, New Jersey; the Department of Obstetrics and Gynecology, University of Colorado, Aurora, Colorado; the Department of Obstetrics and Gynecology, Emory University, Atlanta, Georgia; the Department of Obstetrics and Gynecology, NewYork Presbyterian-Queens Hospital, Flushing, New York; the Department of Obstetrics and Gynecology, Stanford University, Stanford, California; the Oregon Health & Science University, Portland, Oregon; the Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, Kansas; and the Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina.
在患有轻度慢性高血压的女性中,较高的产前脉压与严重妊娠前和早产风险的增加有关. 然而,它可能与较低的怀孕年龄出生体重较小的出生率有关.
科学领域:
- 产科和妇科 产科和妇科
- 怀孕中的心脏病学
- 围产儿医学 围产儿医学
背景情况:
- 慢性高血压影响着很大一部分怀孕.
- 在怀孕期间管理轻度慢性高血压需要仔细监测母亲和胎儿的健康状况.
- 脉压,即静缩和放缩血压之间的差异,可能提供额外的预后信息.
研究的目的:
- 调查产前脉压与母亲和围产期不良结果之间的关联.
- 为了确定脉冲压是否可以预测妊娠中并发症,而妊娠中并发症是轻度慢性高血压.
主要方法:
- 慢性高血压和怀孕 (CHAP) 试验数据的二次分析.
- 包括2325名患有轻度慢性高血压的妇女.
- 使用后勤回归模型来评估产前脉压平均值与复合不良结果之间的关联,调整为治疗分配.
主要成果:
- 平均产前脉压升高 (50.2 ± 7.9 mm Hg) 与复合不良结果的风险增加有关.
- 具体来说,较高的脉压与具有严重特征的妊娠前相关,以及35周前医疗指示的早产.
- 在增加脉压和低于妊娠年龄的出生体重在第五百分点以下之间观察到负相关性.
结论:
- 产前脉压与不良的妊娠结果有着适度的关联,包括具有严重特征的妊娠前和预先分娩的迹象.
- 与严重的怀孕年龄较小的出生体重的反向关系需要进一步调查.
- 脉压可以作为一个有价值的标记在怀孕期间管理慢性高血压.
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