WU Juan-li,WANG Guang-hua,ZOU Li-ling,et al.The prevalence, risk factors of HDP and its association with adverse pregnancy outcomes[J].同济大学学报（医学版）,2015,36(3):117-122. [点击复制]
The prevalence, risk factors of HDP and its association with adverse pregnancy outcomes
WU Juan-li,WANG Guang-hua,ZOU Li-ling,LI Jue
(Dept. of Public Health and Preventive Medicine, Medical College, Tongji University, Shanghai 200092, China)
Abstract:
Objective To evaluate the prevalence and risk factors of hypertensive disorders of pregnancy (HDP), to explore its association with adverse pregnancy outcomes. Methods We performed a retrospective study of all the pregnancies delivered in Shanghai First Maternity and Infant Health Institute and the Tenth People's Hospital from January to December 2010. Multiple logistic regression was applied to evaluate risk factors of HDP, and its relationship with mode of delivery and adverse maternal and perinatal outcomes. Results A total of 7347 pregnant women were investigated, among which 182 suffered from HDP with a prevalence rate of 2.48%. Risk factors were identified with multiple logistic regression, including maternity age＞35, overweight/obesity, basic systolic blood pressure ＞120mmHg, basic diastolic blood pressure＞80mmHg, family history of hypertension, multiparity, primiparous and complicated heart disease. While number of antenatal care visits＞8 was a protective factor for HDP. Spontaneous delivery as a reference, The rate of cesarean in HDP group increased (OR=10.09,5%CI:5.61-18.16),while there was no significant increase in induced delivery rate (P＞0.05). Normal birth weight as a reference, the rate of birth weight＜2500g in HDP group was increased than control group (OR=7.44,5%CI:5.15-10.75). The rate of 1min Apgar score＜7, jaundice, transfer or referral to pediatric department, intrauterine growth retardation, premature abruption, postpartum hemorrhage were increased among pregnant women with HDP, the ORs(95%CI) were 3.14 (1.25-7.91), 26.53 (4.41-159.72), 3.94 (2.31-6.73), 8.45(2.85-25.09), 5.30 (1.20-23.33) and 1.27(1.27-8.01), respectively. No significant difference was found between two groups in the rate of 5min Apgar score＜7 and perinatal death (P＞0.05). Conclusion Advanced maternal age, overweight/obesity, higher basic blood pressure and other factors can increase the risk of HDP, corresponding measures (balanced diet, weight control, regular prenatal care visit and blood pressure monitor) should be taken to decrease the prevalence of HDP and reduce adverse maternal and perinatal outcomes.
