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目的探讨母亲妊娠期和围生期因素对儿童血压的影响,为深入探讨妊娠期与围生期相关因素对儿童血压的长期影响机制提供基础数据。方法对无锡市1993—1995年建立的出生队列于儿童期进行随访,并对其进行身高、体重和血压的测量,采用t检验、多元线性回归分析、多因素Logistic回归等方法进行统计分析。结果共随访到2 256名年龄在10~13岁的儿童。正常出生体重组儿童的收缩压(SBP)和舒张压(DBP)分别为(100.40±10.58)、(65.45±8.95)mmHg;高出生体重儿童的SBP和DBP分别为(99.81±9.96)、(65.02±8.65)mm Hg,差异均无统计学意义(t值分别为1.90,1.33,P值均>0.05)。调整性别、儿童期年龄、儿童期体质量指数(BMI)和生活行为因素,将母亲妊娠期和围生期相关因素纳入多因素模型,结果显示,母亲妊娠时职业为“其他”儿童的儿童期收缩压较低;在正常出生体重组,非第1胎儿童的收缩压较高,儿童收缩压随着出生时身长的增加而增加,母亲产时有妊高症儿童的收缩压较高,且血压升高的风险增加(OR=3.13,95%CI=1.33~7.32);在高出生体重组,母亲产时有妊高症儿童的血压较高,血压升高风险也增加(OR=2.96,95%CI=1.44~6.08)。结论母亲产时妊高症是儿童期血压升高的重要危险因素。应采取一定的措施,预防控制孕妇妊娠期血压升高或妊高症的发生。
Objective To investigate the influence of maternal gestational and perinatal factors on blood pressure in children and provide basic data for further study on the long-term effects of pregnancy-related and perinatal-related factors on blood pressure in children. Methods The birth cohort established in 1993-1995 in Wuxi City was followed up during childhood. The height, weight and blood pressure were measured. The t test, multivariate linear regression analysis and multivariate Logistic regression were used to analyze the birth cohort. Results A total of 2 256 children aged 10 to 13 years were followed up. SBP and DBP in normal birth weight group were (100.40 ± 10.58) and (65.45 ± 8.95) mmHg, respectively; SBP and DBP in high birth weight children were (99.81 ± 9.96) and (65.02 ± 8.65) mm Hg, the differences were not statistically significant (t values were 1.90,1.33, P values were> 0.05). Adjusting gender, childhood age, BMI, and behavioral behavioral factors incorporated mothers ’gestational and perinatal factors into a multivariate model and found that mothers’ occupations during pregnancy were “other” children Systolic blood pressure was lower in childhood; in normal birth weight group, systolic blood pressure was higher in non-first-birth children, systolic blood pressure increased with birth length, and systolic blood pressure was higher in mothers with gestational hypertension (OR = 3.13, 95% CI = 1.33-7.32). In high birth weight group, the children with PIH had higher blood pressure and increased risk of blood pressure (OR = 2.96, 95% CI = 1.44 ~ 6.08). Conclusion Maternal pregnancy-induced hypertension is an important risk factor for childhood hypertension. Should take certain measures to prevent and control pregnant women, pregnancy-induced hypertension or pregnancy-induced hypertension.