浙江省舟山市40819名孕妇妊娠期血压变化趋势及影响因素研究

Study on change trend of blood pressure and related factors in 40 819 pregnant women in Zhoushan, Zhejiang

目的描述浙江省舟山市40 819名孕妇妊娠期血压的变化趋势,并分析其影响因素。方法采用回顾性分析,对2001年1月至2016年12月期间在浙江省舟山市妇幼保健院进行围产保健并住院分娩的40 819名孕妇的血压变化趋势进行描述,并采用多因素广义估计方程分析其影响因素。结果随着孕周增加,孕妇的平均收缩压(SBP)和平均舒张压(DBP)均呈上升趋势;孕妇的年龄越大,孕前体质量指数(BMI)越大,孕期血压水平越高。此外,孕妇文化程度越高,孕期DBP也会越高,但对SBP的影响不显著。孕妇分娩史和胎儿性别对血压无显著性影响。多因素广义估计方程分析结果显示,孕前BMI、孕妇年龄、孕龄、文化程度与孕期SBP、DBP有关,而孕妇产次、胎儿性别等与孕期SBP、DBP关系不明显。结论孕妇年龄、孕前BMI、孕龄、文化程度是影响孕期血压升高的主要因素。孕期血压的监测管理应贯穿整个孕期,在体重管理过程中应特别关注孕前超重或肥胖以及高龄孕妇的血压管理工作。

Objective To describe and analyze the change trend of blood pressure and related factors in 40 819 pregnant women in Zhoushan of Zhejiang province. Methods The change trend of blood pressure in 40 819 pregnant women who had perinatal health care and delivery in Zhoushan Maternal and Child Health Care Center from January 2001 to December 2016 were described. The influence factors were analyzed by using multi factor generalized estimation equation. Results The average systolic blood pressure（SBP） and diastolic blood pressure（DBP） of pregnant women increased with gestational age.The higher the age of pregnant women and their body mass index（BMI） before pregnancy were, the higher the level of blood pressure during pregnancy was. The higher the pregnant women＇s educational levels were, the higher the DBP of pregnant women were during pregnancy, but the effect on SBP was not significant. The birth history of pregnant women and the sex of the fetus had no significant influence on pregnant women＇s blood pressure. The results of multivariate analysis showed that pre pregnancy BMI, maternal age, gestational age and educational level were related to SBP and DBP during pregnancy.Conclusion The age, BMI before pregnancy, gestational age and educational level of pregnant women were the main factors influencing the rise of blood pressure during pregnancy. Therefore, the monitoring and management of pregnant women＇s blood pressure should be carried out throughout the pregnancy. For the weight management, special attention should be paid to the management of blood pressure in pregnant women who are overweight or obese before pregnancy and in older pregnant women.