妊娠期高血壓疾病嚴重程度對母嬰結局的影響及主要危險因素分析

曹玉英

【摘要】 目的：分析妊娠期高血壓疾病嚴重程度對母嬰結局的影響及主要危險因素分析。方法：選取2017年1月-2019年7月本院收治的86例妊娠期高血壓疾病患者作為觀察組，將觀察組分為妊娠期高血壓37例（A組），輕度子癇前期28例（B組），重度子癇前期21例（C組），并選取同期80例正常妊娠者作為對照組。對比各組的妊娠結局和新生兒結局變化，并對影響妊娠期高血壓疾病的因素進行分析。結果：對照組的剖宮產率、胎盤早剝率、產后出血率均顯著低于觀察組，差異均有統計學意義（P<0.05）;A組、B組的剖宮產率、胎盤早剝率、產后出血率均低于C組，A組均低于B組，差異均有統計學意義（P<0.05）。對照組Apgar評分高于觀察組、A組、B組與C組，A組、B組Apgar評分均高于C組，A組Apgar評分高于B組（P<0.05）。對照組的新生兒窒息與胎兒窘迫發生率均明顯低于觀察組、B組與C組，A組與B組的新生兒窒息率與胎兒窘迫率均低于C組（P<0.05）。單因素結果顯示，年齡、孕次、高血壓家族史和負性情緒以及孕前BMI等和妊娠期高血壓疾病發生有重要關系（P<0.05）。多因素回歸分析結果顯示，年齡>27歲、孕次≥2次、BMI≥28 kg/m2、有高血壓家族史以及有負性情緒是導致妊娠期高血壓疾病發生的主要危險因素（P<0.05）。結論：妊娠期高血壓疾病越嚴重其母嬰結局越差，而影響妊娠期高血壓疾病發生的因素包括年齡、孕次、高血壓家族史、負性情緒和孕前BMI，臨床需加強對上述指標的觀察，便于針對性的制定預防措施，以此保證母嬰健康和安全。

【關鍵詞】 妊娠期高血壓疾病 母嬰結局 危險因素

[Abstract] Objective： To analyze the influence of severity of hypertension in pregnancy on maternal and infant outcomes and the main risk factors. Method： A total of 86 patients with gestational hypertension admitted to our hospital from January 2017 to July 2019 were selected as the observation group. The observation group was divided into 37 cases of gestational hypertension （group A）， 28 cases of mild preeclampsia （group B）， and 21 cases of severe preeclampsia （group C）， and 80 cases of normal pregnancy in the same period were selected as the control group. The changes of pregnancy outcome and neonatal outcome in each group were compared， and the factors influencing hypertension in pregnancy were analyzed. Result： The cesarean section rate， placental abruption rate and postpartum hemorrhage rate in the control group were significantly lower than those in the observation group， with statistically significant differences （P<0.05）. The cesarean section rate， placental abruption rate and postpartum hemorrhage rate of group A and group B were lower than those of group C， while those of group A were lower than those of group B， with statistically significant differences （P<0.05）. Apgar score of control group was higher than that of observation group， group A， group B and group C， Apgar score of group A and group B were higher than that of group C， and Apgar score of group A was higher than that of group B （P<0.05）. The incidence of neonatal asphyxia and fetal distress in the control group were significantly lower than those in the observation group， group B and group C，?and the incidence of neonatal asphyxia and fetal distress in group A and group B were lower than those in group C （P<0.05）. Univariate results showed that age， gestational status， family history of hypertension， negative mood and pre-pregnancy BMI were significantly correlated with the occurrence of hypertension during pregnancy （P<0.05）. The results of multivariate regression analysis showed that age > 27 years old， second trimester， BMI ≥ 28 kg/m2，?family history of hypertension and negative emotions were the main risk factors for hypertension in pregnancy （P<0.05）. Conclusion： The more serious the hypertensive diseases in pregnancy， the worse the maternal and infant outcomes will be， and the factors affecting the occurrence of hypertensive diseases in pregnancy include age， gestational grade， family history of hypertension， negative mood and pre-pregnancy BMI. Therefore， it is necessary to strengthen the observation of the above indicators in clinical practice to facilitate the formulation of targeted preventive measures， so as to ensure the health and safety of maternal and infant.[Key words] Gestational hypertension Maternal and child outcomes Risk factorsFirst-authors address： Shunde Hospital， Jinan University， Foshan 528305， China

妊娠期高血壓疾病是一種常見的產科并發癥，也是目前導致圍生兒死亡的主要因素之一。其治病機制復雜，不僅受母體基礎病理影響，還和妊娠期環境因素等有關，若不及時干預治療，隨病情發展還會影響患者生命安全[1-2]。為此，加強妊娠期高血壓疾病早期預防和治療顯得尤為重要。近期，有學者發現，妊娠期高血壓疾病嚴重程度和母嬰結局之間存在聯系[3]，但我國對此研究相對較少，導致臨床無法有效的判斷其病情程度對母嬰結局的影響，很容易延誤時機，進而影響母嬰安全。基于此，本研究特選取86例妊娠期高血壓疾病患者，分析不同病情程度對母嬰結局的影響，同時對影響妊娠期高血壓疾病的因素展開探討，現將研究結果報道如下。……