妊娠期高血压、子痫前期及子痫与孕前和孕期体质量及其他因素的相关性研究

摘要

目的:探讨妊娠期高血压、子痫前期及子痫与孕前体质量指数(BMI)和孕期体质量增长及其他因素的相关性.方法:本研究纳入2013年1月1日至2014年12月31日在四川大学华西第二医院住院分娩的孕妇共10422例,其中患病组(患妊娠期高血压、子痫前期及子痫)349例,未患病组(未患妊娠期高血压、子痫前期及子痫)10073例.采用Logistics回归分析孕前、孕期体质量及其他因素与妊娠期高血压、子痫前期及子痫的相关性及不同BMI分类与其的相关性.结果:Logistics回归分析示,对于所有孕妇,年龄、孕前BMI过高(包括孕前超重、孕前肥胖)、多胎妊娠、辅助生殖技术受孕、慢性高血压及妊娠期高血压疾病史是妊娠期高血压、子痫及子痫前期的独立危险因素,孕前偏瘦为其保护性因素.通过BMI分层以后,对于孕前BMI正常的孕妇,年龄、BMI、孕期总体质量增长、多胎妊娠、辅助生殖技术、慢性高血压、妊娠期高血压疾病史是3种疾病的独立危险因素;对于孕前超重的孕妇,其危险因素只包括孕前BMI、辅助生殖技术受孕和慢性高血压.结论:孕前BMI过高、多胎妊娠、辅助生殖技术受孕、妊娠期高血压疾病史使妊娠期高血压、子痫及子痫前期的发生风险明显增加;孕前BMI、辅助生殖技术受孕和慢性高血压可能增加孕前体质量正常和超重孕妇妊娠期高血压、子痫及子痫前期的发生风险;孕期体质量增长与妊娠期高血压、子痫及子痫前期的发生关系不明显.%Objective:To explore the correlation of gestational hypertension,preeclampsia and eclampsia with pre-pregnancy body mass index (BMI) and gestational weight gain and other risk factors.Methods:A total of 10442 women who delivery between January 1,2013 and December 31,2014 in the West China Second Hospital,Sichuan University were enrolled in this retrospective study,including 349 patients in the gestational hypertension,preeclampsia and eclampsia group,10073 patients in normal pregnancy group.Logistic regression analysis was used to identify the correlation between pre-pregnancy BMI and gestational weight gain and other risk factors with gestational hypertension,preeclampsia and eclampsia.Results:To all women in the study,age,pre-pregnancy BMI,multiple pregnancy,IVF,chronic hypertension and history of hypertension in pregnancy are the independent risk factors for gestational hypertension,preeclampsia and eclampsia,while the normal pre-pregnancy BMI is a protective factor.In the normal pre-pregnancy BMI women,the independent risk factors for gestational hypertension,preeclampsia and eclampsia with the all women.While in the overweight women,only pre-pregnancy BMI,IVF and chronic hypertension are independent risk factors for gestational hypertension,preeclampsia and eclampsia.Conclusions:High pre-pregnancy BMI,multiple pregnancy,IVF,chronic hypertension and history of hypertension in pregnancy increasing the risk of gestational hypertension,preeclampsia and eclampsia.High pre-pregnancy BMI,IVF and chronic hypertension may increase the risk of gestational hypertension,preeclampsia and eclampsia in normal gestational weight and overweight pregnant women.The gestational weight gain was not having significant correlation with gestational hypertension,preeclampsia and eclampsia.