妊娠期高血压患者视网膜病变及其与围生儿预后的关系

Retinopathy in patients with hypertension during pregnancy and its relationship with perinatal prognosis

目的探讨妊娠期高血压患者的视网膜病变及其与围生儿预后的关系。方法前瞻性选取2016年1月至2019年6月复旦大学附属妇产科医院收治的妊娠期高血压患者196例,随访围生儿预后情况,观察母体视网膜病变分期与围生儿预后不良的关系,分析早产儿视网膜病变与母体妊娠期高血压严重程度和视网膜病变分期的关系。结果视网膜分期为III期患者的围生儿预后不良的发生率(62.50%)最高,显著高于视网膜分期为I期和II期的患者(6.86%,12.86%;χ^2=32.554,P<0.001)。早产儿视网膜病变分期与妊娠期高血压患者严重程度呈正相关关系(r=0.45,P<0.001)。早产儿视网膜病变分期与妊娠期高血压患者视网膜病变分期也呈正相关关系(r=0.41,P<0.001)。结论妊娠期高血压患者视网膜严重程度与围生儿不良预后有关,其中早产儿视网膜病变程度与母体妊娠期高血压疾病严重程度和视网膜病变严重程度密切相关。

Objective To explore the retinopathy in patients with hypertension during pregnancy and its relationship with the perinatal prognosis.Methods A total of 196 patients with hypertension diagnosed during pregnancy were prospectively selected from Fudan University Hospital of Obstetrics and Gynaecology from January 2016 to June 2019.The relationship between maternal retinopathy stage and poor prognosis of perinatal infants were observed,and the relationship between premature infant retinopathy and severity degree of maternal hypertension and retinopathy stage were analyzed.Results Patients with retinal stage III had the highest incidence of poor prognosis in perinatal infants(62.50%),which were significantly higher than those with retinal stages I and II(6.86%,12.86%;χ^2=32.554,P<0.001).The severity of retinopathy in preterm infants was positively correlated with severity of gestational hypertension(r=0.45,P<0.001).There was also a positive correlation between the retinopathy stage in preterm infants and the retinopathy stage in patients with hypertension during pregnancy(r=0.41,P<0.001).Conclusion Retinopathy in patients with hypertension during pregnancy is related to the poor prognosis of perinatal infants.The degree of retinopathy of prematurity is closely related to the severity of maternal hypertension and retinopathy in pregnancy.