妊娠期高血压疾病危险因素及对其母婴预后的影响

The Analysis of Hypertensive Disorder Complicating Pregnancy Risk Factors and the Prognostic Analysis on Maternal and Children

目的探讨妊娠期高血压疾病发生的危险因素以及对母婴预后的影响。方法采集148例妊娠期子痫前期患者发生的可能危险因素,并对可能危险因素进行单因素Logistic回归分析和多元Logistic回归分析。从围生儿死亡、胎儿窘迫、新生儿窒息和早产等4个方面探讨妊娠期高血压疾病对围生儿的影响,分析妊娠期高血压疾病严重程度和不同分娩方式对孕产妇的影响。结果单因素Logistic回归分析显示年龄、体质指数、产次、流产史、高血压史、母亲妊娠期高血压疾病史等6项因素为妊娠期高血压疾病的危险因素,多元Logistic回归分析显示年龄、体质指数、产次、高血压史、母亲妊娠期高血压疾病史等5项因素为妊娠期高血压疾病发生的独立危险因素。在围生儿死亡、胎儿窘迫、新生儿窒息和早产等围生儿意外发生率上,子痫前期远高于对照组,且与子痫前期严重程度相关。自然分娩比剖宫产更容易诱发抽搐,重度妊娠期高血压疾病患者更容易发生抽搐。结论妊娠期高血压疾病发生存在多种危险因素,并对母婴预后产生多种不利影响。

Objective To investigate the risk factors of hypertensive disorder complicating pregnancy（HDCP） and the prognostic analysis on maternal and child.Methods 148 cases of HDCP were collected.Among them the possible risk factors were analyzed with univariate logistic regression.Then multivariate logistic regression were further used to demonstrate the risk factors.The effects of HDCP on the perinatal children death,fetal distress,neonatal asphyxia and premature birth in the perinatal children were investigated.The severity of HDCP and different modes of delivery on maternal convulsions during the birth process were explored.Results The result of univariate Logistic regression showed that age,body mass index,parity,abortion history,history of hypertension,history of mothers HDCP were the risk factors of HDCP.The result of multivariate logistic regression showed that age,body mass index,parity,history of hypertension,history of mothers HDCP were the independent risk factors of HDCP.In the perinatal death,fetal distress,neonatal asphyxia and premature birth,HDCP group was far higher than healthful maternal group,and had positive correlation with HDCP severity.Natural childbirth was more likely to cause maternal convulsions than cesarean section.Whether in natural childbirth or cesarean section,moderate and severe HDCP were more prone to cause maternal convulsions.Conclusion There are several risk factors related with HDCP occurring,and HDCP produce a variety of adverse effects on maternal and children.