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Hypertension:高血压前期孕妇,在怀孕期间可能也需要控制血压!

2016-02-02 QQduhp 译 MedSci原创

据CDC的数据显示,近1/3的美国成年人处于高血压前期(血压高于正常值,但不足以列为高血压)。若民众收缩压120-139mm/Hg和(或)舒张压80-89 mm/Hg被称为高血压前期。 既往研究指出,孕妇患高血压增加死产风险,但很少有研究评估高血压前期的孕妇出现这些风险的高低。 产科工作作为一个临床医生,我经常遇到的女性“临界高血压,”我想知道如果他们的不良胎儿结局的风险增加了妇产科学副教授Ann

据CDC的数据显示,近1/3的美国成年人处于高血压前期状态(血压高于正常值,但不足以列为高血压)。民众收缩压120-139mmHg和(或)舒张压80-89 mmHg被称为高血压前期。 

既往研究指出,孕妇患高血压会增加死产风险,但很少有研究评估高血压前期孕妇出现这些风险的高低。
 
妇产科学副教授Anna-Karin Wikstrom博士指出,许多女性并不知道高血压前期对胎儿及她们分娩过程的影响。她和她的同事将研究成果发表在AHA。

研究人员从斯德哥尔摩-哥得兰岛产科数据库中收集了2008-2014年发生的超过15万女性的医疗记录并进行分析。参与的女性均为单胎妊娠、孕周超过37周且孕期血压不超过140/90mmHg。

研究人员评估了孕妇孕20周前和孕34周后的血压状况,特别关注的是她们的舒张压变化。 

此外,研究人员统计了SGA(小于胎龄儿)——该研究中定义为出生体重低于同样妊娠周数胎儿的2.5%的婴儿数目及死胎的数量。 

总的来说,11%的女性孕期会出现高血压前期。有194名死胎和2426名SGA婴儿。与在怀孕期间血压保持正常的孕妇相比,怀孕36周前出现高血压前期的女性,出现死胎的风险高出70%,出现小于胎龄儿的风险高出69%。 

舒张压增加15%的孕妇出现小于胎龄儿的风险是正常血压孕妇的两倍多。此外,无论孕妇是否出现高血压前期,舒张压每增加1%,则分娩小于胎龄儿的风险增加2%。
 
在考虑了母亲的年龄、体重、吸烟和糖尿病诊断等因素后,这些结论仍然存在。 

虽然研究人员表示他们的研究是观察性的,并不存在高血压前期增加不良胎儿状况的风险的因果关系,但是该研究结果可以作为一个对广大孕妇的忠告,提醒女性在怀孕期间控制她们的血压。 

原始出处:

Prehypertension in late pregnancy linked to poorer fetal outcomes,MNT.2,Feb,2016

Anna-Karin Wikström et al.Prehypertension in pregnancy and risks of small for gestational age infant and stillbirth,Hypertension,1 Feb,2016

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    2016-09-20 feather89
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    2016-02-16 青争

    受用了

    0

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    2016-02-07 1de48a27m96(暂无匿称)

    非常好

    0

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