子痫前期再发与初发的临床特点及妊娠结局的研究

目的:探讨子痫前期(PE)再发与初发的临床特点及相关影响因素。方法:回顾分析2010年8月至2015年5月在我院住院并分娩的PE孕产妇的临床资料,其中PE再发组(RPE组)50例,经产妇初发组(MPE组)173例,初产妇初发组(PPE组)230例。结果:RPE组与MPE组的家族史、体重指数(BMI)、疾病严重程度及新生儿情况、不良妊娠结局(胎儿生长受限、胎盘早剥、HELLP综合征)、产检情况、分娩方式等均无明显差异(P0.05)。RPE组的分娩孕周早于MPE组,其中合并慢性高血压及糖尿病要多于MPE组,差异有统计学意义(P0.05)。RPE组与PPE组的分娩孕周、诊断孕周、BMI、合并慢性高血压、最高收缩压、舒张压及S/D比值、分娩方式、新生儿出生1min Apgar评分及是否规律产检比较,差异均有统计学意义(P0.05);MPE组与PPE组比较时,这些差异仍存在。结论:子痫前期再发组的分娩孕周、诊断孕周与初次发生子痫前期患者相比缩短,疾病严重程度明显高于初发初产组,且内科合并症及不良妊娠结局增加,新生儿出生情况较差。此外,BMI增加以及不规律产检也是其再发的影响因素。

Research on the clinical features and pregnancy outcomes of the first time occurring pre-eclampsia and recurrent preeclampsia

Objective:To investigate the clinical features and related factors of first time occurring preeclampsia and recurrent preeclampsia. Methods:Select and analyze women who delivered and had a preeclampsia history in our hospital from Aug. 2010 to May 2015. Ca-ses were divided into three groups:recurrent preeclampsia group( RPE group) ,first time occur-ring preeclampsia of multipara group( MPE group) and first time occurring preeclampsia of pri-mipara group( PPE group) . Results:There was no significant difference of family history,body mass index ( BMI ) , severity of disease, birth condition of newborns, adverse pregnancy out-comes,delivery type and prenatal examination between RPE group and MPE group(P>0. 05). RPE group which had chronic hypertension or diabetes was significantly higher than that in MPE group(P<0. 05),as well as the interval between pregnancies. In RPE group,gestational weeks of parturition were earlier than that in MPE group. RPE group compared with PPE group, gestational weeks when the diagnosis was made,gestational weeks of parturition,body mass in-dex ( BMI ) , chronic hypertension, systolic blood pressure ( SBP ) , diastolic blood pressure (DBP),S/D,1minute Apgar score,delivery type and regular prenatal examination had statisti-cal significance(P<0. 05). These differences still existed when MPE group compared with PPE group. Conclusions:Gestational weeks when the diagnosis was made and gestational weeks of parturition in RPE group were shorter and the severity of disease was higher than primipara groups of first time occurring preeclampsia. The medical complications and adverse pregnancy outcomes also increased. Neonatal birth condition worsened. In addition, increased body mass index( BMI) and irregular prenatal examinations are the factors which influence the recurrence of PE.