张亚光,
刘琴,
谢燕丽,
怀莹莹^,
江苏大学附属昆山市第一人民医院 妇产科，江苏 昆山 215300

详细信息 作者简介: 张亚光（1972-），男，副主任医师。E-mail：1017554790@qq.com




通讯作者: 怀莹莹，主治医师。E-mail：15190162402@163.com 中图分类号: R714.25


摘要:目的探讨妊娠期高血压患者再次妊娠发生子痫前期的影响因素及其分娩结局。 方法回顾性分析2017年1月至 2021年 12 月在昆山市第一人民医院产科产检并分娩的有妊娠期高血压病史，并再次妊娠的73例患者的病例资料，将其按再次妊娠是否发生子痫前期分为病例组（n=49）和对照组（n=24），比较两组的孕次、产次、终止妊娠孕周、再次妊娠年龄、妊娠间隔时间、孕期体重增幅、阿司匹林使用情况、高血压家族史、是否规律产检、妊娠并发症及新生儿出生体重等的差异。分析妊娠期高血压患者再次妊娠发生子痫前期的危险因素及相关指标的预测价值。结果（1）病例组与对照组在此次发病年龄、孕次、产次的比较中差异无统计学意义（P＞0.05），而在终止妊娠孕周及新生儿出生体重的比较中差异有统计学意义（P＜0.05）。在两组并发症的比较中，病例组的胎儿生长受限（FGR）、早产的发生率高于对照组，差异有统计学意义（P＜0.05）。（2）妊娠间隔时间、孕期体重增幅、阿司匹林的使用与妊娠期高血压患者再次妊娠发生子痫前期密切相关（均P＜0.05）。（3）Logistic回归分析结果显示，妊娠间隔时间长、孕期体重增幅大，未使用阿司匹林是再次妊娠发生子痫前期的独立危险因素（P＜0.05）。（4）妊娠间隔时间、孕期体重增幅及二者联合预测妊娠期高血压患者再次妊娠发生子痫前期的ROC曲线下面积分别为0.669，0.693，0.759（P＜0.05）。结论妊娠期高血压患者再次妊娠发生子痫前期的危险因素较多，尤其要关注妊娠间隔时间、控制孕期体重增幅，注意阿司匹林的使用，加强监控、积极预防有助于改善母儿结局。
关键词: 妊娠期高血压病史/
再次妊娠/
子痫前期/
危险因素


Abstract:ObjectiveTo evaluate the risk factors of preeclampsia and delivery outcome in patients with a history of pregnancy-induced gestational hypertension.MethodsThe clinical data of 73 pregnant women with a prior history of gestational hypertension, who received obstetric examination and delivered in the First People's Hospital of Kunshan from January 2017 to December 2021, were retrospectively analyzed. The patients were divided into case group (n=49) and control group (n=24) according to whether pre-eclampsia occurred during the second pregnancy. The number of pregnancies, number of deliveries, week of pregnancy termination, age at second pregnancy, interpregnancy interval, weight gain during pregnancy, aspirin use, family history of hypertension, regular prenatal examination, pregnancy complications and neonatal birth weight were compared between the two groups.Results(1) There were no significant differences between the two groups in age, number of pregnancie and number of deliveries (P＞0.05), but there were significant differences in the week of pregnancy termination and neonatal birth weight (P＜0.05). In the comparison of complications between the two groups, the incidence of fetal growth restriction and premature delivery in the case group were significantly higher than those in the control group (P＜0.05). (2) The interpregnancy interval, weight gain during pregnancy and use of aspirin were closely related to the occurrence of preeclampsia in patients with history of gestational hypertension (all P＜0.05). (3) Logistic regression analysis revealed that long interpregnancy interval, significant weight gain during pregnancy, and no use of aspirin were independent risk factors for recurrent preeclampsia (P＜0.05). (4) The areas under ROC curve for interpregnancy interval, gestational weight gain, and their combined prediction of recurrent preeclampsia during the second pregnancy in patients with a history of gestational hypertension were 0.669, 0.693, and 0.759, respectively (P＜0.05).ConclusionThere are many risk factors for preeclampsia during the second pregnancy in patients with a history of gestational hypertension. It is particularly important to pay attention to the interpregnancy interval, control weight gain during second pregnancy and the use of aspirin. Enhanced monitoring and proactive prevention can help improve maternal and neonatal outcomes.
Keywords:history of gestational hypertension/
second pregnancy/
preeclampsia/
risk factors

PDF全文下载地址:

https://journal.dmu.edu.cn/data/article/export-pdf?id=65645f50fa89b26c22aba8d6