目的 回归分析妊娠高血压疾病(HDP)的危险因素,为其预防提供证据支持。方法 选取2016-01至2017-12在天津市东丽区、河东区、河北区等多家社区建本的孕妇队列,随机抽取具有妊娠结局的3747例,将其中309例患有HDP的患者为观察组,剩余3438例为对照组进行统计分析。对潜在影响因素进行单因素logistic分析,考虑到各因素间可能存在相互作用,进一步采用多因素logistic模型分析。最后,通过单因素分析HDP导致分娩的严重不良结局,以及新生儿出生42 d内的发育情况。结果 单因素logistic分析显示,HDP与年龄、初检体重指数,家族高血压史、高血压史,以及妊娠期高危情况,如辅助生殖技术、妊娠期糖尿病、血清游离甲状腺素异常等有关。多因素logistic分析显示,初检BMI(OR=1.172,95%CI:1.138~1.207)、家族高血压史(OR=6.599,95%CI:3.670~11.865)、高血压史(OR=7.415,95%CI:3.431~16.027)及辅助生殖技术(OR=3.406,95%CI:1.767~6.566)作为危险因素,对HDP有影响。通过单因素分析,得到HDP对分娩方式、分娩孕周、产后42 d的血压,新生儿的出生体重、身长及42 d的体重有影响。结论 对于初检BMI较大的、有家族高血压史、高血压史、采用辅助生殖技术妊娠的孕妇做好早期预防,减少对分娩方式、分娩孕周、及产后42 d的血压及新生儿发育的影响。
Abstract
Objective To analyze the risk factors of pregnancy-induced hypertension and provide evidence support for its prevention. Methods A total of 3747 pregnant women with pregnancy outcomes were randomly selected from a cohort of pregnant women in Dongli District, Hedong District and Hebei District of Tianjin from January 2016 to December 2017. Three hundred and nine patients with gestational hypertension were selected as the observation group, and the remaining 3438 cases were regarded as the control group for statistical analysis. Single factor logistic analysis was conducted on potential influencing factors. Considering the possible interaction among all factors, a multi-factor logistic model was further used for analysis. Finally, a univariate analysis was conducted to investigate the severe adverse outcomes of pregnancy-induced hypertension and the developmental status of newborns within 42 days of birth. Results Single factor logistic analysis showed that gestational hypertension was related to age, body mass index at initial examination, family history of hypertension, hypertension, and high-risk conditions during pregnancy, such as assisted reproductive technology, diabetes during pregnancy, and abnormal serum free thyroid hormone, etc. Multivariate logistic analysis showed that initial BMI (OR=1.172, 95%CI:1.138-1.207), family history of hypertension (OR=6.599, 95%CI: 3.670-11.865), history of hypertension (OR=7.415, 95%CI:3.431-16.027), and assisted reproductive technology (OR=3.406, 95%CI:1.767-6.566) were risk factors for gestational hypertension. Through univariate analysis, it was found that gestational hypertension had an impact on delivery mode, gestational week, postpartum blood pressure at 42 days, birth weight, length and weight of newborns at 42 days. Conclusions Early prevention measures should be carried for pregnant women with high initial BMI, family history of hypertension, history of hypertension, and pregnancy with assisted reproductive technology, so as to reduce the impact on delivery methods, gestational weeks, postpartum blood pressure at 42 days and neonatal development.
关键词
妊娠高血压 /
广义线性回归模型 /
危险因素
Key words
pregnancy-induced hypertension /
generalized linear regression model /
risk factor
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基金
天津市科技计划项目(15ZXJZSY00010)
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