摘要
目的:探讨妊娠合并非重度慢性高血压患者孕期不同血压控制水平对妊娠结局的影响。方法:选取2010年1月~2016年10月在上海仁济医院正规产检并分娩的妊娠合并非重度慢性高血压孕妇303例,根据孕期平均舒张压将患者分为非严格控压组102例(平均舒张压≥90mm Hg)和严格控压组201例(平均舒张压<90mm Hg)。比较两组的妊娠结局,进行多因素Logistic回归分析。结果:调整混杂因素后,非严格控压组的早产(37.3%vs 17.9%,a OR=2.39,95%CI为1.31~4.37)、胎儿宫内窘迫(12.7%vs 6.0%,a OR=2.60,95%CI为1.03~6.58)、小于胎龄儿(21.6%vs 10.4%,a OR=2.28,95%CI为1.08~4.81)和新生儿转入NICU(20.6%vs 6.0%,a OR=3.53,95%CI为1.47~8.46)发生率均显著高于严格控压组。结论:非重度慢性高血压孕妇孕期严格控制血压更利于改善妊娠结局。
Objective： To assess the effect of less-tight vs tight control of blood pressure on the pregnancy outcomes of mild-to-moderate chronic hypertensive women. Methods： Medical histories of mild-to-moderate chronic hypertensive women who had regular prenatal visits and delivered in Shanghai Renji Hospital during Jan. 2010 to Oct. 2016 were collected. 303 eligible women were enrolled and divided into two groups according to their median diastolic blood pressure measured during each prenatal visit.Among these women,102 cases were in less-tight control group（ median diastolic blood pressure ≥90 mm Hg） and 201 cases in tight control group（ median diastolic blood pressure 90 mm Hg）. The adverse maternal and perinatal outcomes were analyzed with the use of a mixed-effects logistic-regression model,with adjustment for the stratification factors.Results： In the less-tight control group,the incidence of premature delivery（ 37.3% vs 17.9%,a OR = 2.39,95%CI 1.31 - 4.37）,fetal distress in uterus（ 12.7% vs 6.0%,a OR = 2.60,95%CI 1.03 ~ 6.58）,small-for-gestational-age newborns（ 21.6% vs 10.4%,a OR =2.28,95%CI 1.08 ~ 4.81） and transfer to neonatal intensive care unit,NICU（ 20.6% vs 6.0%,a OR = 3.53,95% CI 1. 47 ~ 8. 46） were significantly higher when compared with those in thetight control group.There was no significant difference in other maternal and perinatal outcomes between two groups.Conclusion： Tight control of blood pressure may be beneficial for mild-tomoderate chronic hypertensive women to improve pregnancy outcomes.
作者
梁超
张琰
祖丽菲娅.阿布力克木
马骁
狄文
张羽
Liang Chao;Zhang Yan;Zu Lifeiya·Abulikemu(Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127;Department of Obstetrics and Gynecology,Shanghai Tenth People＇s Hospital,Shanghai 200072;Department of Obstetrics,People＇s Hospital of Xinjiang Uygur Autonomous Region,Urumchi 830001)
出处
《现代妇产科进展》
CSCD
北大核心
2018年第6期401-404,共4页
Progress in Obstetrics and Gynecology
基金
国家自然科学基金面上项目(No:81270714)
上海市卫生和计划生育委员会公共卫生三年行动计划重点学科--妇产科学(No:15GWZK0701)
关键词
回顾性队列研究
非重度慢性高血压
血压控制
孕妇并发症
围产儿结局
Retrospective cohort study
Mild-to-moderate chronic hypertension
Control of blood pressure
Maternal complication
Perinatal outcome
