甘肃省少数民族地区妊娠高血压综合征流行病学调查及对母婴结局的影响

Epidemiological survey of pregnancy-induced hypertension syndrome in Gansu province and the influence on maternal and neonatal outcomes

目的分析甘肃省少数民族地区孕产妇妊娠高血压综合征(pregnancy-induced hypertension syndrome,PIHS)流行病学调查及其对母婴结局的影响。方法选取2017年1月至2020年2月,甘肃省妇幼保健院收治的甘肃少数民族地区孕妇750例,依据是否出现PIHS分为观察组和对照组,比较两组患者临床资料,采用单因素及多因素logistic回归分析导致甘肃少数民族地区孕产妇PIHS的危险因素,比较两组母婴结局。结果 750例孕妇中,出现妊娠高血压综合征80例,发生率10.67%;单因素及多因素logistics回归分析发现,年龄≥30岁、体质量指数(body mass index,BMI)≥24 kg/m^(2)、高血压家族史、经济收入、早产史、可溶性血管内皮生长因子受体1(soluble fms-like tyrosine kinase receptor 1,sFlt-1)为导致孕产妇PIHS的独立危险因素(OR=1.30、1.27、1.37、1.25、1.33、1.34,P<0.05);定期产检、高密度脂蛋白胆固醇(high density liptein cholesterol,HDL-C)、载脂蛋白A1(Apolipoprotein A1,ApoA1)为保护因素(OR=0.77、0.77、0.83,P<0.05)。观察组胎盘早剥率、产后出血率、并发症发生率及新生儿窒息发生率、围产儿死亡率高于对照组,差异有统计学意义(χ^(2)=6.148、6.973、6.303、4.285、4.185,P<0.05);观察组中子痫患者并发症发生率、新生儿窒息发生率高于子痫前期患者,差异有统计学意义(χ^(2)=11.703、10.812,P<0.05)。结论甘肃少数民族地区孕产妇PIHS发生率高,其相关危险因素较多,且PIHS对母婴结局也有不良影响,应加以预防。

Objective To understand the epidemiological characteristics of pregnancy-induced hypertension syndrome(PIHS) in pregnant women in minority areas of Gansu and to discuss the influence on maternal and neonatal outcomes. Methods During January 2017 and February 2020, 750 pregnant women from Gansu minority areas treated in Maternal and Child Health Hospital of Gansu were enrolled and divided into observation group and control group according to the presence or absence of PIHS.The clinical data of the two groups were compared, and risk factors for PIHS in pregnant women in Gansu minority areas were determined by univariate and multivariate logistic regression analysis.Maternal and neonatal outcomes of the two groups were also discussed. Results 80 out of 750 pregnant women had PIHS, with an overall incidence of 10.67%.Univariate and multivariate logistic regression analysis showed that ageof ≥30 years old, body mass index(BMI) of ≥24 kg/m^(2), family history of hypertension, financial status, history of premature delivery and soluble vascular endothelial growth factor receptor 1(sFlt-1) were independent risk factors for maternal PIHS(OR=1.30, 1.27, 1.37, 1.25, 1.33, 1.34, P<0.05), while regular prenatal care, high-density lipoprotein cholesterol (HDL-C)and apolipoprotein A1(ApoA1)were protective factors(OR=0.77,0.77,0.83,P<0.05).The incidence rates of placental abruption,postpartum hemorrhage,complications and neonatal asphyxia,and perinatal mortality rate in the observation group were significantly higher than those in the control group (χ^(2)=6.148,6.973,6.303,4.285,4.185,P<0.05).In the observation group,the incidence rates of complications and neonatal asphyxia in women with eclampsia were higher than that of those with preeclampsia(χ^(2)=11.703,10.812,P<0.05). Conclusions The incidence rate of PIHS in pregnant women in Gansu minority areas is high with many risk factors involved.PIHS also has adverse effects on maternal and neonatal outcomes.