母亲妊娠期和围生期因素对儿童血压的影响

Effects of maternal gestational and perinatal factors on blood pressure of offspring

目的探讨母亲妊娠期和围生期因素对儿童血压的影响,为深入探讨妊娠期与围生期相关因素对儿童血压的长期影响机制提供基础数据。方法对无锡市1993—1995年建立的出生队列于儿童期进行随访,并对其进行身高、体重和血压的测量,采用t检验、多元线性回归分析、多因素Logistic回归等方法进行统计分析。结果共随访到2 256名年龄在10-13岁的儿童。正常出生体重组儿童的收缩压（SBP）和舒张压（DBP）分别为（100.40±10.58）、（65.45±8.95）mmHg;高出生体重儿童的SBP和DBP分别为（99.81±9.96）、（65.02±8.65）mm Hg,差异均无统计学意义（t值分别为1.90,1.33,P值均〉0.05）。调整性别、儿童期年龄、儿童期体质量指数（BMI）和生活行为因素,将母亲妊娠期和围生期相关因素纳入多因素模型,结果显示,母亲妊娠时职业为＂其他＂儿童的儿童期收缩压较低;在正常出生体重组,非第1胎儿童的收缩压较高,儿童收缩压随着出生时身长的增加而增加,母亲产时有妊高症儿童的收缩压较高,且血压升高的风险增加（OR=3.13,95%CI=1.33-7.32）;在高出生体重组,母亲产时有妊高症儿童的血压较高,血压升高风险也增加（OR=2.96,95%CI=1.44-6.08）。结论母亲产时妊高症是儿童期血压升高的重要危险因素。应采取一定的措施,预防控制孕妇妊娠期血压升高或妊高症的发生。

Objective To explore the effects of maternal gestational and perinatal factors on blood pressure of children.Methods A birth cohort from 1993 to 1995 in Wuxi was followed up to childhood.Questionnaire survey and physical examination,including height,weight,systolic blood pressure（SBP） and diastolic blood pressure（DBP） in childhood were conducted.Chisquare test,multi-linear regression and multi-logistic model were used.Results A total of 2 256 children aged 10 to 13 years old was followed up.Among normal birth weight group,the SBP and DBP of children were（100.40±10.58） mm Hg and（65.45±8.95）mm Hg.While in large birth weight group,the SBP and DBP of children were（99.81±9.96） mm Hg and（65.02±8.65） mm Hg,respectively.No statistical significant difference was found.After adjusting sex,age and BMI in childhood,lifestyles of children,maternal gestational and perinatal factors,multivariate regression model revealed that maternal occupation had effects on SBP among all children.Among normal birth weight group,children who were not the first parity had higher SBP and SBP increased with birth length,compared with children whose mother had no pregnancy-induced hypertension,those whose mother had pregnancy-induced hypertension had higher SBP and proportion of elevated BP（OR = 3.13,95% CI： 1.33- 7.32）.Among large birth weight group,children whose mother had pregnancy-induced hypertension had higher SBP,DBP and proportion of elevated BP（OR = 2.96,95%CI： 1.44-6.08）.Conclusion Pregnancy-induced hypertension is a risk factor for high blood pressure of children.Some strategies should be proposed to manage gestational hypertension.