厄瓜多尔孕妇产前控制与先兆子痫发病率之间的关系:横断面研究

Karina Tite-Tibanquiza, Irina Guzmán-Chávez, Luis Dutan-Yupangui, María del Cisne Quito-Cabrera
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摘要

高血压疾病是影响妊娠的主要并发症之一,也是导致孕产妇和胎儿高死亡率的最重要原因之一。大约 80% 的病例发生在足月妊娠期,而其余比例的病例则开始于较早的妊娠期。大多数子痫前期病例发生在健康孕妇身上。因此,在产前检查中确定风险因素非常重要。产前检查是对孕妇进行全面监测的基础。众所周知,妊娠高血压是一种常见的、对母亲、胎儿和新生儿具有潜在危险的并发症。因此,产前保健的目标之一就是检测妊娠前高血压和妊娠诱发高血压综合征(子痫前期)。我们使用了 2018 年全国健康与营养调查(ENSANUT)中具有全国代表性的 20648 名母亲样本。我们使用了多重共线性检验来排除可能存在的统计建模问题,并使用二元逻辑线性回归模型来估计每个自变量的比值比(OR)及其 95% 置信区间(95% CI)。此外,我们还使用了特异性测试来检验因变量与自变量之间的拟合程度。我们的结果显示,产前控制可将妊娠期间出现子痫前期等并发症的概率降低 2 倍(OR=-2.0005;CI=-1.981;-2.055)。这一结果具有统计学意义(P<0.05)。研究还表明,与其他人群相比,来自农村地区、收入较低、受教育程度较低的妇女更容易在怀孕期间出现并发症。子痫前期-子痫仍然是对孕产妇和围产期发病率和死亡率影响最大的病症之一,因此应继续努力寻找预防其发生或改变其演变的方法,避免子痫或其他严重形式的疾病。这项研究的结果表明,充分的产前保健(从怀孕头三个月开始,进行五次以上的产前检查)对预防子痫前期等妊娠并发症有影响,因为识别和避免子痫前期是产前保健的主要目的之一。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between Prenatal Control and the Incidence of Preeclampsia in Ecuadorian Pregnant Women: A Cross-Sectional Study
Hypertensive disorders are one of the main complications that affect pregnancy, which makes them one of the most important causes of high maternal and fetal morbimortality. Approximately 80% of cases occur at term gestational age, while the remaining percentage begin at earlier gestational ages. Most cases of preeclampsia occur in healthy pregnant women. Therefore, it is important to establish the risk factors in prenatal control visits. Prenatal control is fundamental in which comprehensive surveillance of the pregnant woman is performed. It is known that hypertension in pregnancy is a frequent and potentially dangerous complication for the mother, fetus and newborn. For this reason, one of the objectives of prenatal care is to detect pre-pregnancy hypertension and pregnancy-induced hypertension syndrome (preeclampsia). A nationally representative sample of 20648 mothers from the National Health and Nutrition Survey 2018 (ENSANUT) was used. We used multicollinearity tests to rule out possible statistical modeling problems and a binary logistic linear regression model where Odds Ratio (OR) with their 95% confidence intervals (95% CI) were estimated for each of the independent variables. In addition, we used specificity tests to test the fit between our dependent and independent variables. Our results reveal that prenatal control reduced 2 times (OR= -2.0005; CI=-1.981;-2.055) the probability of suffering complications during pregnancy such as preeclampsia. This result is statistically significant (p<0.05). It was also demonstrated that women from rural areas, with lower income and low schooling are more susceptible to suffer complications during pregnancy compared to the rest of the population. Preeclampsia-eclampsia continues to be one of the pathologies that has the greatest impact on maternal and perinatal morbidity and mortality, so work should continue to find ways to prevent its onset or modify its evolution, avoiding eclampsia or other severe forms of the disease. The results found in this study showed that adequate prenatal care (more than five visits starting in the first trimester of pregnancy) has an impact on the prevention of pregnancy complications such as preeclampsia, since identifying and avoiding it is one of the main purposes of prenatal care.
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