Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The...Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.展开更多
Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9...Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.展开更多
Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, w...Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.展开更多
目的调查妊娠高血压疾病（hypertensive disorders of pregnancy,HDP）的患病率,及危险因素,探究HDP与不良妊娠结局的关系。方法采用回顾性调查法,选取2010年1月至12月期间在上海第一妇婴保健院、第十人民医院住院分娩的所有孕产妇作为...目的调查妊娠高血压疾病（hypertensive disorders of pregnancy,HDP）的患病率,及危险因素,探究HDP与不良妊娠结局的关系。方法采用回顾性调查法,选取2010年1月至12月期间在上海第一妇婴保健院、第十人民医院住院分娩的所有孕产妇作为研究对象。以Logistic回归分析评估HDP相关危险因素,探索HDP与分娩方式、母婴不良结局之间的关系。结果 7 347例孕产妇中,有182例发生HDP,患病率为2.48%。多因素Logistic回归分析显示,分娩年龄〉35岁、超重/肥胖、基础收缩压〉120 mmHg、基础舒张压〉80 mmHg、高血压家族史、多胎、初产、合并心脏病是HDP的危险因素,而产检次数〉8则是HDP的保护性因素。以自然分娩为参照,HDP组剖宫产率高于对照组（OR=10.09,95%CI：5.61-18.16）,产钳助产率则无统计学差异（P〉0.05）。两组母婴不良结局比较：以出生体重正常组为参照,HDP组婴儿出生体重〈2 500 g的发生率高于对照组（OR=7.44,95%CI：5.15-10.75）;以分娩孕周正常组为参照,HDP组分娩孕周〈37周的发生率高于对照组（OR=4.99,95%CI：3.56-7.02）;HDP组新生儿1 min Apgar评分〈7（OR=3.14,95%CI：1.25-7.91）、黄疸（OR=26.53,95%CI：4.41-159.72）、新生儿转儿科或转院（OR=3.94,95%CI：2.31-6.73）、胎儿宫内生长迟缓（OR=8.45,95%CI：2.85-25.09）、胎盘早剥（OR=5.30,95%CI：1.20-23.33）、产后出血发生率均高于对照组（OR=1.27,95%CI：1.27-8.01）,而5 min Apgar评分〈7、围产儿死亡发生率则无统计学差异（P〉0.05）。结论妊娠高血压疾病的发生是多种因素作用的结果,它与分娩年龄、超重/肥胖、基础血压等因素密切相关。因此,建议孕妇饮食营养均衡、控制体重,定期进行产前检查、监测血压变化,以降低HDP患病率,减少母婴不良结局的发生。展开更多
文摘Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.
文摘Hypertensive disorders of pregnancy (HDP) are the most common maternal and perinatal health challenges. Globally, the incidence of HDP increased from 16.30 million to 18.08 million, with a total increase of about 10.9% from 1990 to 2019. Umbilical Doppler study in hypertensive disorders of pregnancy helps to predict neonatal outcomes and prevent neonatal and maternal morbidity and mortality. Objective: This study aims to determine the incidence of abnormal umbilical Doppler among hypertensive pregnant women, to identify the adverse neonatal outcomes associated with abnormal umbilical Doppler, and also to detect the diagnostic predictive values of umbilical Doppler to neonatal outcomes at KCMC. Material and methods: A hospital-based prospective cohort study included women with hypertensive disorders of pregnancy from the gestational age of 28 weeks and above, followed up to delivery during the study period from August 2022 to March 2023. Multivariate logistic regression analysis was used to determine the association between AUD and neonatal outcomes. Results: Out of 112 women with HDP, the incidence of abnormal umbilical Doppler was 38 (33.93%). Abnormal umbilical Doppler was associated with neonates with low birth weight aOR (95% of CI) of 4.52 (1.59 - 12.83) p = 0.005 and neonatal ICU admission 9.71 (2.90 - 32.43) p Conclusion: The incidence of abnormal umbilical Doppler is high in hypertensive disorders of pregnancy which is associated with an increase in neonatal low birth weight and neonatal ICU admissions, the sensitivity of abnormal umbilical Doppler in prediction of low birth weight and neonatal ICU admission is significant hence the routine use of umbilical Doppler assessment among hypertensive pregnant women is crucial.
基金The present study was supported by the National Natural Science Foundation of China(Grant No.82003415)the National Key Research&Development(R&D)Program of China(Grant No.2021YFC2700705).
文摘Inconsistent findings have been reported regarding the associations between hypertensive disorders in pregnancy (HDP) and infant neurodevelopment. Leveraging data from the Jiangsu Birth Cohort, in the present study, we re-visited such associations in one-year-old infants from 2 576 singleton pregnancies and 261 twin pregnancies. We first assessed infant neurodevelopment by the Bayley Scales of Infant and Toddler Development Screening Test (the Third Edition), and then estimated its association with maternal HDP using general linear regression models and Poisson regression models. In singleton pregnancies, compared with mothers unexposed to HDP, infants born to mothers with chronic hypertension exhibited a lower score (β, −0.67;95% confidence interval [CI], −1.19-−0.15) and a higher risk of "non-optimal" gross motor development (risk ratio [RR], 2.21;95% CI, 1.02-4.79);in twin pregnancies, infants born to mothers with HDP exhibited lower scores in cognition (β, −0.49;95% CI, −0.96-−0.01), receptive communication (β, −0.55;95% CI, −1.03-−0.06), and gross motor (β, −0.44;95% CI, −0.86-−0.03), and at a higher risk of "non-optimal" gross motor development (RR, 2.12;95% CI, 1.16-3.88). These findings indicate that infants born to mothers with HDP may have inferior neurodevelopment outcomes at the age of one year.
文摘目的调查妊娠高血压疾病（hypertensive disorders of pregnancy,HDP）的患病率,及危险因素,探究HDP与不良妊娠结局的关系。方法采用回顾性调查法,选取2010年1月至12月期间在上海第一妇婴保健院、第十人民医院住院分娩的所有孕产妇作为研究对象。以Logistic回归分析评估HDP相关危险因素,探索HDP与分娩方式、母婴不良结局之间的关系。结果 7 347例孕产妇中,有182例发生HDP,患病率为2.48%。多因素Logistic回归分析显示,分娩年龄〉35岁、超重/肥胖、基础收缩压〉120 mmHg、基础舒张压〉80 mmHg、高血压家族史、多胎、初产、合并心脏病是HDP的危险因素,而产检次数〉8则是HDP的保护性因素。以自然分娩为参照,HDP组剖宫产率高于对照组（OR=10.09,95%CI：5.61-18.16）,产钳助产率则无统计学差异（P〉0.05）。两组母婴不良结局比较：以出生体重正常组为参照,HDP组婴儿出生体重〈2 500 g的发生率高于对照组（OR=7.44,95%CI：5.15-10.75）;以分娩孕周正常组为参照,HDP组分娩孕周〈37周的发生率高于对照组（OR=4.99,95%CI：3.56-7.02）;HDP组新生儿1 min Apgar评分〈7（OR=3.14,95%CI：1.25-7.91）、黄疸（OR=26.53,95%CI：4.41-159.72）、新生儿转儿科或转院（OR=3.94,95%CI：2.31-6.73）、胎儿宫内生长迟缓（OR=8.45,95%CI：2.85-25.09）、胎盘早剥（OR=5.30,95%CI：1.20-23.33）、产后出血发生率均高于对照组（OR=1.27,95%CI：1.27-8.01）,而5 min Apgar评分〈7、围产儿死亡发生率则无统计学差异（P〉0.05）。结论妊娠高血压疾病的发生是多种因素作用的结果,它与分娩年龄、超重/肥胖、基础血压等因素密切相关。因此,建议孕妇饮食营养均衡、控制体重,定期进行产前检查、监测血压变化,以降低HDP患病率,减少母婴不良结局的发生。
