前次子痫前期临床特征对再发子痫前期的影响

The influence of clinical features during the previous pre-eclampsia of pregnant women on their recurrence of pre-eclampsia

目的:分析前次子痫前期临床特征对再发子痫前期发生率及发病孕周的影响。方法:回顾性收集2016年1月-2018年12月本院产科住院分娩有子痫前期病史的经产妇155例孕妇,分析子痫前期病史临床特征对再发子痫前期及对本次发病不同孕周(<34周与≥34周)影响。结果:本次再发子痫前期组与非再发组比较,前次妊娠发病孕周≤28周、妊娠间隔≥5年、妊娠收缩压≥160mmHg、舒张压≥110mmHg及尿蛋白≥2.0g/24h所占比例有差异(P<0.05),而前次妊娠终止孕周、妊娠伴严重并发症两组无差异(P>0.05)。前次妊娠发病孕周≤28周、妊娠收缩压≥160mmHg、舒张压≥110mmHg是再发子痫前期的独立危险因素(P<0.05),前次妊娠发病孕周28~34周、妊娠间隔≥5年及尿蛋白≥2.0g/24h与再发子痫前期无相关性(P>0.05);本次发病孕周<34周与≥34周比较,其前次妊娠发病孕周≤28周、妊娠收缩压≥160mmHg及舒张压≥110mmHg所占比例有差异(P<0.05),前次妊娠终止孕周、妊娠间隔≥5年、尿蛋白≥2.0g/24h、伴严重并发症无差异(P>0.05)。结论:前次子痫前期发病孕周较早、血压较高是再发子痫前期独立危险因素,还会影响再发子痫前期的发病孕周。

Objective:To analyze the influence of clinical features during the previous pre-eclampsia of pregnant women on their pre-eclampsia recurrence rate and the gestational weeks of pre-eclampsia onset again.Methods:The clinical data of 155 pregnant women with a history of pre-eclampsia from January 2016 to December 2018 were collected retrospectively,and were divided in group A(women with pre-eclampsia again)and group B(women without pre-eclampsia again).The influence of clinical features during last pre-eclampsia of pregnant women on their pre-eclampsia recurrence rate and the different gestational weeks(<34 and≥34 gestational weeks)of pre-eclampsia onset again was analyzed.Results:There were statistically significant different in proprotions of the previous pre-eclampsia onset≤28 gestational weeks,pregnancy interval≥5 years,systolic blood pressure during pregnancy≥160mmHg,diastolic blood pressure≥110mmHg,and urine protein≥2.0g/24h of women between group A and group B(P<0.05),but there were no difference in the gestational weeks for pregnancy termination of the previous pregnancy and the rate of serious complications of women between the two groups(P>0.05).Pre-eclampsia onset≤28 gestational weeks,systolic blood pressure≥160mmHg,diastolic blood pressure≥110mmHg during the previous pregnancy were independent risk factors of recurrent preeclampsia(P<0.05).Pre-eclampsia onset in 28-34 gestational weeks,pregnancy interval≥5 years,and urine protein≥2.0g/24h had no correlation with recurrent preeclampsia(P>0.05).There were statistically significant different in proprotions of the previous pre-eclampsia onset≤28 gestational weeks,systolic blood pressure≥160mmHg and diastolic blood pressure≥110mmHg during last pregnancy between women with pre-eclampsia onset<34 gestational weeks and women with pre-eclampsia onset≥34 gestational weeks(P<0.05),but there were no difference in the gestational weeks of pregnancy termination of last pregnancy,pregnancy interval≥5 years,urine protein≥2.0g/24h,and severe complications rate of women between the two groups(P>0.05).Conclusion:The early onset pre-eclampsia and severe hypertension occurrence during the previous pregnancy are the independent risk factors for the recurrence of pre-eclampsia,and also affect gestational weeks of pre-eclampsia onset again.