早晨血压和高风险怀孕的不良妊娠结果
Ruimin Zhang1, Yiwen Fang1, Yongqiang Ma2,3
1Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China.
概括
孕产妇的早晨血压 (BP) 监测有助于识别不良妊娠结果. 同时发生的早晨高血压和夜间或白天的高血压显著放大了风险,特别是在怀孕28周到34周之间.
科学领域:
- 产科和妇科 产科和妇科
- 怀孕期间的心血管健康
- 孕产妇和胎儿医学 孕产妇和胎儿医学
背景情况:
- 母亲早晨血压 (BP) 和不良妊娠结果 (APO) 之间的关系尚未完全理解.
- 高危妊娠需要精确的血压监测,以便及时干预.
- 现有的BP测量方法可能无法捕获关键的时间模式.
研究的目的:
- 调查母亲早晨血压水平与各种不良妊娠结果 (APO) 之间的关联.
- 与传统的办公室血压相比,评估结合早晨血压测量的诊断准确性.
- 确定与增加APO风险相关的特定BP门和模式.
主要方法:
- 对1833例高风险单子怀孕的回顾性队列研究,使用门诊门诊血压监测.
- 分析晨间,非晨间白天,夜间和办公室血压测量之间的相关性.
- 使用后勤回归和灵敏度分析评估早晨BP模式和复合APO风险之间的关联.
主要成果:
- 26.7%的孕妇表现出早晨高血压.
- 晨间血压与非晨间白天和夜间血压有很强的相关性,但与办公室血压有适度的相关性.
- 将早晨的血压添加到评估中,提高了各种高血压类型的诊断准确度.
- 确定了早晨BP和复合APO风险之间的J形关联 (值≥132/79 mmHg).
- 同时发生的早晨高血压和夜间或非早晨白天高血压显著放大了APO风险 (ORs 3.16-3.41).
- 在怀孕28-34周之间同时发生的早晨和夜间高血压 (OR 5.50) 发现了最强的风险放大.
结论:
- 孕产妇的早晨血压测量是查和识别怀孕期间高风险血压模式的宝贵工具.
- 结合的早晨和夜间高血压构成了APO最重要的风险,特别是在妊娠的第三季度.
- 门诊血压监测,包括早晨读数,为管理妊娠高血压提供了优越的诊断准确性,超过仅仅是办公室的血压.
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