早发型子痫前期与妊娠结局的关系及相关因素分析

目的 探讨早发型（妊娠＜34周）子痫前期与患者妊娠结局的关系以及明确发生早发型子痫前期的相关因素。方法 回顾性分析2008年1月至2013年1月在本院妇产科进行分娩的纳入符合研究标准的孕产妇25360例的临床资料，对发生早发型子痫前期的孕妇的相关因素进行分析，并对妊娠结局的影响进行分析。结果 早发型子痫前期的孕妇有96例，占0．37％，其中12例在妊娠34周后分娩。孕妇年龄≥35岁（ P ＝0．006；95％ CI ，1．309～5．135）、初产（ P ≤0．001；95％ CI ，2．525～5．052）、糖尿病（ P ≤0．001；95％ CI ，2．029～8．669）、慢性高血压（ P ≤0．001；95％ CI ，9．112～37．303）、先天性异常（ P ≤0．001；95％C I ，2．632～11．222）是早发型子痫前期的高危因素。早发型子痫前期患者在围产期发生不良结果较非早发型子痫前期患者严重，其中与新生儿病死相关因素包括：胎死、小于胎龄儿、围产期新生儿死亡。结论 依据早发型子痫前期的相关因素以及可能的妊娠结局，可以尽早区别孕产妇情况和预防干预妊娠结局。

Relationship Between Early-onset Preeclampsia and Pregnancy Outcome and the Analysis of the Related Factors

Objective] To explore the relationship between early‐onset （＜ 34 weeks of gestation） pre‐eclampsia and pregnancy outcome in order to identify the associated factors of early‐onset preeclampsia .Methods]Clinical data of 25360 pregnant and lying‐in women who were enrolled in the study of gynecological and obstetrical department in our hospital from Jan .2008 to Jan .2013 were analyzed retrospectively .The cor‐related factors of early‐onset preeclampsia were analyzed .The influence on pregnancy outcome was analyzed .Results] There were 96 pregnant women with early‐onset preeclampsia（0 .37% ） .Among them ,12 women delivered after 34 weeks of gestation .The maternal age（≥35 years old ,P=0 .006 ,95% CI ,1 .309~5 .135） , primiparity（ P ≤0 .001 ,95% CI ,2 .525~5 .052） ,diabetes mellitus（ P ≤0 .001 ,95% CI ,2 .029~8 .669） , chronic hypertension（ P ≤0 .001 ,95% CI ,9 .112~37 .303） and congenital anomalies（ P ≤0 .001 ,95% CI , 2 .632~11 .222） were high risk factors of early‐onset preeclampsia .The poor outcome in women with early‐onset preeclampsia was severer than that in women without early‐onset preeclampsia .The factors associated with the fatality of neonates were fetal death ,small for gestational age infant and perinatal death .Conclu‐sion]Based on the correlated factors and possible pregnancy outcome of early‐onset preeclampsia ,the condition of pregnant and lying‐in women can be distinguished as early as possible ,and the pregnancy outcome can be prevented and intervened .