妊娠期高血压疾病患者产后血压恢复的相关因素分析

Influence factors of postpartum blood pressure recovery in patients with gestational hypertension

目的探讨妊娠期高血压疾病患者产后45 d血压恢复情况和影响产后血压恢复的相关因素。方法收集2015年7月至2018年4月在江苏省如皋市人民医院住院分娩的妊娠期高血压疾病153例患者的临床资料,根据产后45 d检查时的血压情况分为产后血压恢复组(126例)和产后血压未恢复组(27例),比较2组患者的基本资料,应用多因素Logistic回归模型分析妊娠期高血压疾病患者产后45 d血压恢复的相关因素。结果产后45 d血压未恢复组年龄、高血压史和轻度、重度子痫前期比例高于产后血压恢复组[(33±4)岁比(28±5)岁、22. 2%(6/27)比5. 6%(7/126)、25. 9%(7/27)比8. 7%(11/126)、14. 8%(4/27)比0. 8%(1/126)],妊娠期补充叶酸比例低于产后血压恢复组[29. 6%(8/27)比67. 5%(85/126)],差异均有统计学意义(均P <0. 05)。Logistic回归分析结果显示,高血压史(比值比=7. 498,95%置信区间:1. 192～47. 180,P=0. 032)、妊娠期高血压疾病程度(比值比=2. 348,95%置信区间:1. 626～4. 216,P=0. 009)、年龄(比值比=2. 250,95%置信区间:1. 179～4. 004,P=0. 023)、妊娠期情绪不佳(比值比=8. 493,95%置信区间:1. 128～63. 949,P=0. 038)为产后血压恢复的危险因素。结论多数妊娠期高血压疾病患者产后45 d内血压可恢复至正常,高血压史、妊娠期高血压疾病病情严重、高龄、妊娠期情绪不佳均可影响产后血压的恢复。

Objective To observe the blood pressure in 45 days after delivery and analyze the influence factors of postpartum blood pressure recovery in patients with gestational hypertension.Method A total of153 patients with gestational hypertension who gave birth in the People’s Hospital of Rugao from July 2015 to April 2018 were divided into normal postpartum blood pressure group(126 cases)and postpartum hypertension group(27 cases)according to the blood pressure levels on the 45 th day after delivery.Risk factors of postpartum hypertension were analyzed by multivariate logistic regression.Results In postpartum hypertension group,age,rates of hypertension history,mild and severe preeclampsia were higher than those in normal postpartum blood pressure group[(33±4)years vs(28±5)years,22.2%(6/27)vs 5.6%(7/126),25.9%(7/27)vs8.7%(11/126),14.8%(4/27)vs 0.8%(1/126)];the rate of folic acid supplementation during pregnancy was lower than that in normal postpartum blood pressure group[29.6%(8/27)vs 67.5%(85/126)](all P<0.05).Logistic regression showed that history of hypertension(odds ratio=7.498,95%confidence interval:1.192-47.180,P=0.032),severity of hypertension during pregnancy(odds ratio=2.348,95%confidence interval:1.626-4.216,P=0.009),age(odds ratio=2.250,95%confidence interval:1.179-4.004,P=0.023)and bad mood during pregnancy(odds ratio=8.493,95%confidence interval:1.128-63.949,P=0.038)were risk factors of the persistence of postpartum hypertension.Conclusions Most patients with gestational hypertension can recover within 45 days after delivery.Postpartum blood pressure can be affected by the history of hypertension,advanced age,the serious condition of hypertension and bad mood during pregnancy.