妊娠高血压综合征与小于胎龄儿的相关性研究

目的 探讨妊娠高血压综合征(PIH)与小于胎龄儿(SGA)之间的关系.方法 研究对象为浙江省和江苏省4个县(市)1995-2000年期间单胎分娩且孕周在28～42周的93 743名妇女.首先计算并比较PIH组(包括不同程度PIH组)与非PIH组孕妇的SGA发生率;采用logistic回归控制孕妇年龄、产次、职业、文化程度、体重指数、孕期贫血严重程度、胎膜早破和新生儿性别等可能的混杂因素后,估计PIH与SGA的关联程度;并按照早产和足月分娩进行分层分析.结果 PIH组孕妇SGA的发生率(6.0%)高于非PIH组(4.5%)(P＜0.001),且随PIH病情的加重,SGA的发生率升高(趋势x2=119.30,P＜0.001).调整可能的混杂因素后,PIH组SGA的发生率是非PIH组的1.37倍(RR=1.37,95%CI:1.22～1.54),轻、中和重度PIH组的RR值(95%CI)分别为1.17(1.01～1.34)、1.69(1.33～2.14)、3.50(2.57～4.77).以早产及足月分娩分层分析后,上述结论基本不变,但早产孕妇中PIH组SGA的RR值大于足月分娩孕妇中PIH组SGA的RR值.结论 PIH与SGA的发生之间存在统计学关联,PIH组SGA的发生率高于非PIH组.

Association of pregnancy-induced hypertension with small-for-gestational-age babies

OBJECTIVE: To examine the association between pregnancy-induced hypertension (PIH) and small-for-gestational-age babies (SGA) in a Chinese population. METHODS: Subjects were women who delivered a singleton baby (gestational weeks: equal to or greater than 28, and less than 42) in four cities or counties in Jiangsu and Zhejiang provinces, China, during the period of 1995 - 2000. A total number of 93 743 women were included. Incidence of SGA was calculated and compared between women with or without PIH and between groups with different severities of PIH. Multiple logistic regression was used to address the relationship between PIH and SGA while controlling for maternal age, occupation, education, parity, BMI, anemia, premature rupture of membranes and fetal sex. The association between PIH and SGA was also examined according to preterm or term delivery. RESULTS: The incidence of SGA in women with PIH (6.0%) was higher than women without (4.5%), and the incidence increased with severities of PIH. The adjusted relative risk rates (95% CI) of SGA in women with mild,moderate and severe PIH were 1.17 (1.01-1.34), 1.69 (1.33-2.14), and 3.50 (2.57-4.77), respectively, when confounders were controlled for. The risk ratios of SGA in women with PIH among women who delivered a preterm baby were higher than those among women who delivered a term baby. CONCLUSION: There seemed a statistical association between PIH and SGA and women with PIH having higher incidence of SGA than those without PIH.