早发型子痫前期发病的危险因素及对分娩结局的影响

杨佳 吴朝勇

[关键词] 早发型子痫前期;危险因素;妊娠结局;安全分娩

[中图分类号] R714.244          [文献标识码] B          [文章编号] 1673-9701（2021）25-0081-04

Influence analysis on risk factors and safe delivery outcome of early onset preeclampsia

YANG Jia   WU Chaoyong

Department of Obstetrics and Gynecology， Keqiao District Maternal and Child Health Hospital in Shaoxing in Zhejiang Province， Shaoxing   312030， China

[Abstract] Objective To explore the correlated risk factors and safe delivery outcome of early onset preeclampsia （EOP）. Methods A total  of 129 cases of EOP in obstetrics and gynecology department of our hospital from June 2019 to December 2020 were chosen as EOP group，and 258 cases of normal pregnancy women without EOP were randomly sampled as control group. The factors such as age， weight gain during pregnancy， history of spontaneous abortion， family history of hypertension， history of preeclampsia， without taking folic acid， hypertensive disorder complicating pregnancy （HDCP）， gestational diabetes mellitus （GDM）， anemia， infection during pregnancy， oligohydramnios， mean arterial pressure （MAP）， increased D-dimer， abnormal transaminase， vtamin E deficiency， peak end systolic/peak end diastolic ratio of uterine artery（S/D） were respectively screened by single factor and multiple factors Logistic regression method， and the difference of pregnancy outcome was compared between the two groups with χ2 test. Results The risk factors of EOP mainly included in age of pregnancy women （OR=2.477）， weight gain during pregnancy （OR=4.023）， HDCP （OR=4.568）， MAP （OR=5.171）， D-dimer increased （OR=4.328）， lack of Vitamin E （OR=3.728） and S/D ratio increased （OR=4.191）. The incidence rates of eclampsia， placental abruption， fetal distress， neonatal asphyxia and cesarean section in the EOP group were all higher than the control group （P<0.05）. Conclusion There are many risk factors affecting the incidence of EOP， and exist interaction among them. Furthermore， the incidence of EOP will seriously affect the pregnancy outcome. To aim directly at these high risk factors， we should early discover， early diagnose， early intervene and treat it， to improve pregnancy outcome of mother and baby.

[Key words] Early onset preeclampsia （EOP）; Risk factors; Pregnancy outcome; Safe delivery

早發型子痫前期（Early onset preeclampsia，EOP）是孕34周前发生高血压、水肿、蛋白尿等症状，EOP具有发病早、病情进展较快、并发症多且重、妊娠结局差等特点[1]，已成为妇产科医生面临的难题之一。EOP的发生和发展可能与基因多态性和基因表达异常、氧化应激、滋养层细胞功能发生异常、胎盘形态学异常、血管内皮细胞炎性反应、胎盘毒性物质释放增加等密切相关[2]，但具体病因机制仍尚未明确。由于EOP发病的孕龄一般相对较早，此阶段胎儿的各项器官功能尚未发育成熟，若能在妊娠中早期就发现孕妇有关EOP的高危因素，有针对性的预防和干预治疗，严密监测母婴安全的前提下尽量延长孕龄，可一定程度上改善母婴妊娠结局[3]。为此，本研究对129例EOP病例和258名正常孕产妇进行回顾性调查，筛选影响EOP发病的相关高危因素，并分析EOP对母婴妊娠结局的影响，现报道如下。