原发性慢性高血压患者妊娠后并发子痫前期的危险因素及母儿结局分析

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目的探讨原发性慢性高血压患者妊娠后并发子痫前期的危险因素及母儿结局。方法回顾性分析2013年5月—2016年5月在即墨市第二人民医院行孕期检查的288例原发性慢性高血压合并妊娠患者,所有患者孕20周前均予以阿司匹林治疗,若患者的血压有2次以上≥150/100 mm Hg,则予以降压药口服治疗,根据出院诊断分为非子痫前期组(n=162例)和子痫前期组(n=126例),比较两组患者的母儿结局,并分析影响不良结局的因素。采用SPSS 20.0进行统计处理,计量资料用均数±标准差(xˉ±s)表示,采用t检验,计数资料用率(%)表示,采用χ2检验;孕期产妇情况与子痫前期的关联分析采用Logistic回归分析,P<0.05表示差异有统计学意义。结果所纳入288例孕妇中,共126例孕妇并发子痫前期,总发生率为43.75%。非子痫前期组与子痫前期组的平均年龄、体质量指数(BMI)分层比较差异无统计学意义(P>0.05);非子痫前期组与子痫前期组的年龄分层、子痫前期史、高血压病程比较差异有统计学意义(P<0.05)。经Logistic回归分析显示,高血压病史>3年,年龄>35岁,子痫前期病史均是影响原发性慢性高血压患者妊娠后并发子痫前期的危险因素。子痫前期组胎死宫内、宫内发育迟缓、胎儿窘迫、胎儿窒息发生率明显高于非子痫前期组,差异均有统计学意义(P<0.05)。结论高血压病史>3年,年龄>35岁,子痫前期病史均是影响原发性慢性高血压患者妊娠后并发子痫前期的危险因素,子痫前期患者胎死宫内、宫内发育迟缓、胎儿窘迫、胎儿窒息发生率明显升高。 Objective To investigate the risk factors and preterm and postnatal outcomes of preeclampsia in pregnant women with primary chronic hypertension. Methods A retrospective analysis of 288 patients with primary chronic hypertension complicated by pregnancy examined at the Second People’s Hospital of Jimo City from May 2013 to May 2016 was carried out with aspirin 20 weeks before their pregnancy. Two times or more ≥150 / 100 mm Hg, the patients were given antihypertensive drugs for oral treatment, and were divided into non-preeclampsia group (n = 162) and preeclampsia group (n = 126) Maternal and child outcomes, and analyze the factors that affect adverse outcomes. SPSS 20.0 was used for statistical analysis. The measurement data were expressed as mean ± standard deviation (xˉ ± s), t test was used and count data was used (%), using χ2 test; correlation analysis of pregnant women and preeclampsia Logistic regression analysis, P <0.05 indicated the difference was statistically significant. Results Among the 288 pregnant women involved, 126 pregnant women with preeclampsia had a total incidence of 43.75%. There were no significant differences in mean age and body mass index (BMI) stratification between non-preeclampsia group and preeclampsia group (P> 0.05); in non-preeclampsia group and preeclampsia group, The course of preeclampsia and hypertension had significant difference (P <0.05). Logistic regression analysis showed that hypertension history> 3 years, age> 35 years and preeclampsia were the risk factors of preeclampsia in patients with primary chronic hypertension. The incidence of fetal death, intrauterine growth retardation, fetal distress and fetal asphyxia in preeclampsia group was significantly higher than that in non-preeclampsia group (P <0.05). Conclusion Hypertension history> 3 years, age> 35 years old, preeclampsia history are the risk factors of pregnancy-induced preeclampsia in patients with essential hypertension, preeclampsia fetal intrauterine and intrauterine growth retardation , Fetal distress, the incidence of fetal asphyxia increased significantly.
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