多囊卵巢综合征孕妇并发妊娠高血压的危险因素分析

Risk Factors of Pregnant Women with Polycystic Ovary Syndrome Complicated with Gestational Hypertension

目的:探讨多囊卵巢综合征(PCOS)孕妇并发妊娠高血压疾病(HDCP)的危险因素。方法:选择郑州大学第一附属医院2019年5月至2021年7月收治的148例PCOS孕妇为研究对象,根据患者有无发生HDCP分为HDCP组(78例)和非HDCP组(70例),根据文献资料及医生临床经验,筛选可能影响PCOS孕妇并发HDCP的相关因素,先后进行logistic单因素及多因素回归分析,判定影响PCOS孕妇并发HDCP的独立因素。结果:单因素分析结果显示,HDCP组孕妇孕前体质量指数(BMI)、高血压家族史、HDCP家族、史被动吸烟史、孕前睾酮及空腹胰岛素水平均高于非HDCP组,学历及家庭月收入低于非HDCP组,差异具有统计学意义(P <0.05);多因素logistic回归分析结果显示,孕前BMI高、高血压家族史、HDCP家族史、孕前睾酮高水平及空腹胰岛素高水平均是PCOS孕妇并发HDCP的危险因素,而学历高及家庭月收入高是PCOS孕妇并发HDCP的保护因素(P <0.05)。结论:高血压家族史、HDCP家族史均可能增加PCOS妊娠孕妇HDCP发病风险,孕期积极降低BMI,行睾酮及胰岛素监测,有助于降低HDCP发病风险。

Objective To explore the risk factors of hypertensive disorder complicating pregnancy(HDCP) in polycystic ovary syndrome(PCOS). Methods A total of 148 pregnant women with PCOS admitted to the First Affiliated Hospital of Zhengzhou University from May 2019 to July 2021 were selected as the study objects. According to whether the patients had HDCP or not, they were divided into HDCP group(78 cases) and non-HDCP group(70 cases). According to the literature and clinical experience of doctors, the factors that may affect the complication of HDCP in pregnant women with PCOS were selected. Logistic univariate and multivariate regression analysis were performed successively to determine the independent factors affecting HDCP in pregnant women with PCOS. Results Univariate analysis showed that pre-pregnancy body mass index(BMI), family history of hypertension, family history of HDCP, history of passive smoking, pre-pregnancy testosterone and fasting insulin levels in HDCP group were higher than those in non-HDCP group, education background and monthly family income were lower than those in non-HDCP group, and the differences were statistically significant(P < 0.05). Multivariate logistic regression analysis showed that high pre-pregnancy BMI, family history of hypertension, family history of HDCP, high pre-pregnancy testosterone level and high fasting insulin level were all risk factors for HDCP in pregnant women with PCOS, and high education and monthly family income were protective factors for HDCP in pregnant women with PCOS(P < 0.05). Conclusion Family history of blood pressure and HDCP may increase the risk of HDCP in pregnant women with PCOS. Active reduction of BMI and monitoring of testosterone and insulin during pregnancy can help reduce the risk of HDCP.