妊娠期高血压发病影响因素病例对照研究

Risk factors of hypertensive disorder in pregnancy:a case-control study

目的了解妊娠期高血压的相关影响因素,为预防妊娠期高血压发病提供参考依据。方法采用以医院为基础的1:2病例对照研究方法对2010年1月1日-8月30日在河北大学附属医院产科住院的62例患妊娠期高血压产妇及同期住院的124名正常产妇进行妊娠期高血压相关影响因素的问卷调查和实验室检查。结果病例组孕前体质指数(BMI)≥25、孕前有高血压史、有高血压家族史、头胎单产、规律补充钙剂、定期孕期检查、孕期情绪不佳、血清白细胞介素-6(IL-6)含量≥20 pg/L和β2-微球蛋白(β2-MG)含量≥1.5 mg/L的比例分别为25.8%、27.4%、38.7%6、9.4%、61.3%、64.5%、22.6%、96.8%和98.4%;对照组分别为8.9%、3.2%、7.3%、49.2%、75.8%、79.8%7、.3%3、5.5%和42.7%,差异均有统计学意义(P<0.05);多因素Logistic回归分析结果表明,孕前BMI≥25、有高血压家族史、头胎单产、孕期情绪不佳和血清IL-6含量≥20 pg/L是妊娠期高血压的危险因素。结论孕前BMI较高、有高血压家族史、头胎单产、孕期情绪不佳和血清IL-6含量较高的产妇患妊娠期高血压的危险性较大。

Objective To explore the risk factors of hypertensive disorder in pregnancy（HDP）.Methods A 1：2 matched case-control study was carried out among 62 cases of pregnant women with HDP（case group） and 124 cases of normal pregnant women（control group）.Single factor and multiple factors logistic regression analysis were used to analyze the risk factors of HDP.Results The results of single factor analysis showed that body mass index（BMI） before preg-nancy≥25（odds ratio=3.573）,hypertension history before pregnancy（OR=11.333）,familial history of hypertension（OR=8.070）,the first-born and single-birth（OR=2.337）,taking calcium irregularly（OR=0.505）,periodic pregnancy examination（OR=0.459）,mental stress during pregnancy（OR=3.727）,and the serum levels of interleukin-6（IL-6）（OR=54.545） and β2-microglobulin（OR=81.717） were associated with HDP.The risk factors significantly associated with HDP were BMI ≥25,history of hypertension,first-born and single-birth,mental stress during pregnancy,and serum level of IL-6 in multiple factor analysis.Conclusion BMI ≥25,history of hypertension,first-born and single-birth,mental stress during pregnancy,and serum level of IL-6 increase the risk of HDP.