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目的:探讨妊娠期高血压疾病(HDCP)严重并发症相关高危因素。方法:对住院分娩诊断为HDCP孕妇年龄、孕、产次、双(多)胎、地区、是否系统产检、高血压病史和妊娠期高血压病史及家族史、HDCP及其严重并发症发病情况、围生儿情况进行调查分析HDCP发病的一般规律、城市/乡村发病的差别以及导致孕产妇及围生儿严重并发症的高危因素。结果:住院孕妇总数为24 154例,其中HDCP患者921例,发生率为3.81%。妊娠高血压、子痫前期、子痫、慢性高血压并子痫前期、妊娠合并慢性高血压分别占HDCP的29.97%、64.60%、2.39%、2.39%、0.65%,产后出血及胎儿宫内生长受限分别占HDCP的50.00%、44.00%。HDCP患者中城市505例,农村416例,合并严重并发症城市10例,农村36例;围产儿不良结局(包括FGR、死胎、新生儿死亡、流产、新生儿窒息等)城市82例,农村129例,将孕妇年龄分为17～20、21～25、26～30、31～35、36～40和≥41岁年龄段,其HDCP发生率分别为6.73%、28.23%、28.66%、21.82%、11.62%、2.93%;在17～20岁年龄段围产儿不良结局发生率比其他年龄段显著增高(P<0.05),孕妇合并严重并发症在各年龄段间差异无统计学意义(P>0.05)。Logistic逐步回归分析低龄、双胎(多胎)、农村地区、文化程度及无系统产检均为HDCP孕妇严重并发症及围生儿不良结局的高危因素。结论:产后出血、早产及胎儿宫内生长受限仍是江西省HDCP孕妇和围生儿最主要的并发症。年龄、农村人口、文化程度≤初中、无系统产检是HDCP孕妇严重并发症及围生儿不良结局的高危因素。
Objective: To investigate the risk factors associated with severe complications of HDCP. Methods: The diagnosis of inpatient delivery HDCP pregnant women age, pregnancy, delivery times, double (multiple) births, regions, whether the system production, history of hypertension and gestational hypertension history and family history, HDCP and its serious complications, Perinatal investigation of the general situation of HDCP incidence, urban / rural differences in the incidence and lead to serious complications of maternal and perinatal risk factors. Results: The total number of hospitalized pregnant women was 24 154, of which 921 were HDCP patients, the incidence was 3.81%. Pregnancy-induced hypertension, preeclampsia, eclampsia, chronic hypertension, preeclampsia and pregnancy-induced hypertension accounted for 29.97%, 64.60%, 2.39%, 2.39%, 0.65% of HDCP, postpartum hemorrhage and intrauterine growth Restricted accounted for 50.00% HDCP, 44.00%. Among the HDCP patients, 505 were in urban areas and 416 in rural areas, 10 were complicated with severe complications, and 36 were rural areas. 82 cases of poor outcome (including FGR, stillbirth, newborn death, abortion, neonatal asphyxia, etc.) For example, the HDCP rates of pregnant women were 6.73%, 28.23%, 28.66% and 21.82%, respectively, divided into 17-20, 21-25, 26-30, 31-35, 36-40 and ≥41 years old, , 11.62% and 2.93% respectively. The incidence of adverse outcomes in perinatal children aged 17-20 was significantly higher than that in other age groups (P <0.05). There was no significant difference in the incidence of serious complications among pregnant women in all age groups (P> 0.05). Logistic stepwise regression analysis showed that HDCP was associated with high risk of serious complications of pregnant women and poor outcomes of perinatal children in younger age, twins (multiple births), rural areas, educational level and non-systematic childbirth. Conclusions: Postpartum hemorrhage, premature birth and fetal growth restriction are still the most common complications of pregnant women and perinatals in HDCP in Jiangxi Province. Age, rural population, educational level ≤ junior high school, non-systematic childbirth HDCP pregnant women with serious complications and perinatal children with high risk factors for adverse outcomes.