子痫前期:患病率,危险因素,以及对母亲和胎儿的影响

Vaibhav Shandilya, Neiketa Sinha, S. Rani
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引用次数: 0

摘要

先兆子痫是妊娠期最常见的高血压疾病之一,全世界有50万孕产妇死亡,50多万胎儿死亡。据估计,在印度等发展中国家,先兆子痫的发病率要高出7倍。患有先兆子痫的女性在以后的生活中患缺血性心脏病、中风和血栓栓塞等心血管疾病的可能性要高出几倍。本研究旨在记录先兆子痫的患病率,检查各种相关危险因素的发生率,并分析先兆子痫对母亲和胎儿的影响。进行了横断面研究。根据医疗记录的可得性随机选择了500名孕妇。确定其中的子痫前期患病率,并进一步研究子痫前期人群的各种危险因素和流行病学因素。对母体和胎儿的影响也进行了研究。从病历中获得的数据输入到MS excel中,变量以频率和比例表示。采用SPSS 26.0软件进行分析,主要数据采用卡方检验确定显著性。在总共500名孕妇中,31名出现了先兆子痫;因此,子痫前期患病率为6.2%。31例先兆子痫妇女中,20 ~ 29岁年龄组占51.6%,其中19例(61.2%)孕前体重指数为bb23,属于超重或肥胖。其中1级肥胖13例(41.9%),2级肥胖5例(16.1%)。仅有2例为多胎,而未产和初产妇女分别占子痫前期妇女的48.38%和45.16%。31名妇女中有20名患有严重的先兆子痫,这与分娩婴儿的出生体重较低显著相关(P < 0.05)。45.1%(31名妇女中的14名)不得不进行早产,48.38%的先兆子痫妇女通过下段剖宫产终止妊娠。其中两名妇女还被诊断为肝酶升高和血小板低综合征。在胎儿结局方面,48.4%的婴儿出生体重过低。宫内胎儿死亡,胎儿生长受限,唇腭裂也记录在少数新生儿。先兆子痫有很高的发病率和死亡率,以及未来心血管疾病的风险增加。因此,个人自控能力中的危险因素,如体重,必须加以调整,以防止不利的并发症。应识别有子痫前期风险的孕妇,并给予高质量的产前护理,以尽量减少母体和胎儿的子痫前期并发症。必须在这个问题上探索更多的研究途径,以便能够出现加强治疗和管理的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preeclampsia: Prevalence, Risk Factors, and Impact on Mother and Fetus
Preeclampsia is one of the most common hypertensive disorders in pregnancy accounting for >50,000 maternal deaths, and over 500,000 fetal deaths worldwide. The incidence of preeclampsia is estimated to be 7 times higher in developing countries like India. Women with preeclampsia are several folds more likely to contract cardiovascular diseases such as ischemic heart disease, stroke, and thromboembolism later in life. This study aims to record the prevalence of preeclampsia, examine the incidence of various associated risk factors and document, and analyze the effects preeclampsia has on the mother and fetus. A cross-sectional study was conducted. Five hundred pregnant women were randomly selected based on availability of medical records. Prevalence of preeclampsia was identified in them and the preeclamptic population was further studied for various risk factors and epidemiological factors. The impact on mother and fetus was also studied. The data obtained from the medical records were entered into MS excel and variables were expressed as frequency and proportions. Analysis was done on SPSS 26.0 and major data were subjected to Chi-square test for determining significance. Out of a total of 500 pregnant women, 31 developed preeclampsia; hence, the prevalence of preeclampsia was found to be 6.2%. Of the 31 preeclamptic women, majority belonged to the 20–29 age group (51.6%), 19 (61.2%) had a pre-pregnancy body mass index >23, thus being classified as overweight or obese. Thirteen of these 19 (41.9%) were obese class 1, while 5 (16.1%) were obese class 2. Only two patients were multiparous, while nulliparous and primiparous women accounted for 48.38 and 45.16% of preeclamptic women. Twenty of the 31 women had preeclampsia with severe features and this was found to be significantly associated with delivering a baby having lower birth weight (P < 0.05). A significant 45.1% (14 of the 31 women) had to undergo preterm delivery and 48.38% of the preeclamptic women terminated pregnancy by a lower segment cesarean section. Two of the women were also diagnosed with elevated liver enzymes and low platelets syndrome. With respect to the fetal outcomes, 48.4% of infants had low birth weight. Intrauterine fetal death, fetal growth restriction, and cleft lip and palate were also documented in few neonates. Preeclampsia has a high morbidity and mortality rate as well as an increased risk for future cardiovascular diseases. Hence, risk factors which are in an individual’s self-control such as weight must be modified to prevent unfavorable complications. Pregnant women at risk of preeclampsia should be identified and high-quality antenatal care should be given to minimize the complications of preeclampsia both for the mother and the fetus. More research avenues must be explored on this subject so that enhanced treatment and management options can emerge.
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