初次妊娠高血压综合征患者再次妊娠发生子痫的高危因素

目的:分析初次妊娠高血压综合征(pregnancy-induced hypertension syndrome,PIH)患者再次妊娠发生子痫的高危因素,为临床早期识别和干预高危患者提供参考依据。方法:回顾性分析2016年10月至2018年10月佛山市妇幼保健院初次妊娠确诊PIH的124例孕妇的资料。依据再次妊娠有无子痫分为发生子痫的观察组(n=37)和未发生子痫的对照组(n=87)。记录两组产妇的初次妊娠年龄和孕周、有无PIH或子痫家族史、初次妊娠后高血压有无恢复、两次妊娠间隔时间、再次妊娠的BMI、再次妊娠孕周、两次妊娠血清血管内皮生长因子(vascularendothelialgrowthfactor,VEGF)和胎盘生长因子(placental growth factor,PLGF)的表达水平等资料。采用单因素和多因素logistic回归分析筛选影响初次妊娠PIH患者再次妊娠发生子痫的高危因素。结果:与对照组比较,观察组的家族史、高血压无恢复、两次妊娠期间血清VEGF和PLGF水平均较高(P<0.05),而妊娠间隔时间较短(P<0.05)。多因素logistic回归分析得出:家族史、高血压无恢复、妊娠间隔时间、血清VEGF和PLGF水平均是影响初次妊娠PIH患者再次妊娠发生子痫的高危因素(P<0.05)。结论:具有家族史、初次妊娠后高血压未恢复、妊娠间隔时间较短、两次妊娠期间血清VEGF和PLGF水平较高的初次PIH患者是再次妊娠发生子痫的高危患者,需要早期干预。

High-risk factors for eclampsia during repregnancy in patients with primary pregnancy-induced hypertension syndrome

Objective:To analyze the high-risk factors for eclampsia during repregnancy in patients with primary pregnancyinduced hypertension syndrome(PIH),in order to early recognize and intervent to high risk patients.Methods:A total of 124 repregnant patients diagnosed to primary PIH in our hospital from Oct.2016 to Oct.2018 were enrolled to respective research.All patients were divided into an observation group(n=37,the occurrence of eclampsia) and a control group(n=87,the non-occurrence of eclampsia) according to the occurrence of eclampsia during repregnancy.The primary pregnant age,gestational weeks,family history of PIH or eclampsia,hypertension recovering after primary pregnancy,pregnancies intervals,BMI of repregnancy,repregnancy weeks,serum vascular endothelial growth factor(VEGF) and placental growth factor(PLGF) levels of the 2 groups were recorded.The high-risk factors for eclampsia during repregnancy in patients with primary PIH were analyzed by univariate and multivariate logistic regression analysis.Results:Compared to the control group,the family history,hypertension without recovering,the serum levels of VEGF and PLGF at the primary pregnancy and repregnancy in the observation group were higher(P<0.05),but the intervals between pregnancies in the observation group were shorter(P<0.05).The family history,hypertension without recovering,intervals between pregnancies,serum levels of VEGF and PLGF were the independent high-risk factors for eclampsia during repregnancy by logistic regression analysis(P<0.05).Conclusion:The with family history,hypertension without recovering,intervals between pregnancies,high serum levels of VEGF and PLGF are high risks in patients with primary PIH,which should be given early intervention.