早发型子痫前期不良妊娠结局影响因素分析

Analysis of influencing factors of adverse pregnancy outcome in early-onset preeclampsia

目的探讨早发型子痫前期发生不良妊娠结局的相关影响因素。方法选取2017年1月-2019年12月在新疆维吾尔自治区人民医院住院并终止妊娠的早发型子痫前期孕妇161例为研究对象。根据是否发生不良妊娠结局,分为不良妊娠结局组(52例)和非不良妊娠结局组(109例)。分析两组不良妊娠结局的影响因素。结果两组孕前体重、孕前体重指数、血肌酐、血尿酸、白蛋白、丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、总胆红素、新生儿体重比较,差异有统计学意义(P<0.05)。白蛋白是早发型子痫前期患者不良妊娠结局的保护因素(OR<1,P<0.05),而孕前体重指数、丙氨酸氨基转移酶是早发型子痫前期患者不良妊娠结局的危险因素(OR>1,P<0.05)。结论对于超重计划妊娠妇女,孕前需加强的膳食指导和体重管理,孕期严密监测肝肾功能变化,特别是白蛋白变化,合理指导病程的治疗决策,减少妊娠不良结局的发生。

Objective To explore the related influencing factors of adverse pregnancy outcome in early-onset preeclampsia.Methods The clinical data of 161 pregnant women with early-onset preeclampsia who hospitalized and terminated their pregnancy in the People’s Hospital of Xinjiang Uygur Autonomous Region from January 2017 to December 2019.According to the adverse pregnancy outcome,they were divided into adverse pregnancy outcome group(52 cases)and non-adverse pregnancy outcome group(109 cases).The influencing factors of adverse pregnancy outcomes in two groups were analyzed.Results There were significant differences between the two groups in prepregnancy weight,prepregnancy body mass index,serum creatinine,serum uric acid,albumin,alanine aminotransferase,aspartate amino transferase,total bilirubin,neonatal weight(P<0.05).Albumin was a protective factor for adverse pregnancy outcome in patients with early-onset preeclampsia(OR<1,P<0.05),while prepregnancy body mass index and alanine aminotransferase were risk factors for adverse pregnancy outcome in patients with early-onset preeclampsia(OR>1,P<0.05).Conclusion For overweight women planning to have a pregnancy,it is necessary to strengthen dietary guidance and weight management before pregnancy,closely monitor changes in liver and kidney function,especially changes in albumin,during pregnancy,and reasonably guide treatment decisions in the course of disease,so as to reduce the occurrence of adverse pregnancy outcomes.