妊娠期高血压对胎儿结局、出生缺陷的影响及相关因素分析研究

Influence of hypertension during pregnancy on fetal outcome and birth defects and related factors

目的探讨HDCP对胎儿结局与出生缺陷的影响及相关因素,为HDCP防治提供依据和参考。方法选择2016年1月-2017年10月科室收治的HDCP患者65例,设为HDCP组;选择同期入院检查的非HDCP患者65例,设为非HDCP组。共计130例,记录并统计2组胎儿分娩后结局;记录并统计2组胎儿娩出后先心病、新生儿缺血缺氧性脑病、体重过低、肺透明膜病及先天畸形等出生缺陷发生率。查阅两组孕册对孕产妇临床资料进行统计、调查,对相关因素进行单因素及多因素Logistic回归分析。结果 HDCP胎儿娩出后宫内窘迫、胎死宫内、生长受限及早产发生率,均高于非HDCP组(P<0.05);HDCP组先心病、新生儿缺血缺氧性脑病、体重过低、肺透明膜病、Apgar<7及先天畸形出生缺陷发生率,均高于非HDCP组(P<0.05);单因素及多因素Logistic回归分析结果表明:妊娠期高血压对胎儿结局、出生缺陷发生率与产检史(定期或系统产检)无统计学意义(P>0.05);妊娠期高血压对胎儿结局、出生缺陷发生率与肥胖、家族史、吸烟史、情绪不佳、高龄妊娠及营养不良关系密切(P<0.05)。结论 HDCP可增加宫内窘迫、胎死宫内、先心病、生长受限等的发生率,导致胎儿结局不良及引起多种出生缺陷,相关因素包括肥胖、情绪不佳、家族史及吸烟史等,应根据相关因素及时制定有效的措施进行干预,改善胎儿结局,降低出生缺陷发生率。

Objective：To investigate the effect of HDCP on fetal outcome and birth defects and related factors to provide the basis and references for the prevention and treatment of HDCP. Methods：Sixty-five HDCP patients admitted to our department from January 2016 to October 2017 were selected as HDCP group and 65 non-HDCP patients were enrolled as non-HDCP group. A total of 130 cases were recorded and the outcomes of 2 groups of fetuses after birth were recorded and recorded. The incidence of birth defects such as congenital heart disease,neonatal hypoxic-ischemic encephalopathy,underweight,hyaline membrane disease and congenital malformations were recorded and statistically analyzed. Check the two groups of pregnant women on maternal clinical data statistics,surveys,the relevant factors single factor and multivariate Logistic regression analysis. Results：HDCP fetus after delivery of intrauterine distress,fetal death,growth restriction and preterm birth were higher than non-HDCP group（P〈0.05）;HDCP group of CHD,neonatal hypoxic-ischemic encephalopathy,underweight,Hyaline membrane disease,Apgar7 and birth defects of congenital malformation were higher than those of non-HDCP group（P〈0.05）. The results of univariate and multivariate Logistic regression analysis showed that gestational hypertension had no significant effect on fetal outcome,birth defects（P〉0.05）;the incidence of pregnancy-induced hypertension and fetus outcome,birth defects and obesity,family history,smoking history,poor mood,advanced pregnancy and nutrition Bad relationship（P〈0.05）. Conclusion：HDCP can increase the incidence of intrauterine distress,fetal death,intrauterine disease,congenital heart disease and limited growth,leading to poor fetal outcomes and multiple birth defects. Related factors include obesity,poor mood,family history and smoking history,Should be based on relevant factors in a timely manner to develop effective measures to intervene to improve fetal outcome and reduce the incidence of birth defects.