Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study.
Prevalence of pre-eclampsia and adverse pregnancy outcomes in women with pre-existing cardiomyopathy: a multi-centre retrospective cohort study.
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DOI：
10.1038/s41598-022-26606-z
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发表时间：
2023-01-04
影响因子：
4.6
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中科院分区：
文献类型：
--
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先兆子痫与产后心功能障碍有关;然而，这种关系的性质仍不确定。这项多中心回顾性队列研究旨在确定预先存在心功能不全（左心室射血分数< 55%）的女性中先兆子痫的患病率，并探讨妊娠结局与孕前心脏表型之间的关系。在该282例妊娠队列中，先兆子痫患病率没有显著增加（4.6% [95% C.I. 2.2-7.0%] vs.人群患病率4.6% [95% C.I. 2.2-7.0%]）。2.7-8.2]，p = 0.99）; 12/13名妇女同时存在先兆子痫的产科/医学风险因素。早产先兆子痫（< 37周）和胎儿生长受限（FGR）的患病率增加（分别为1.8% vs. 0.7%，p = 0.03; 15.2% vs. 5.5%，p < 0.001）。收缩和舒张功能均与妊娠结局无关。胎儿生长阻滞剂（n = 116）与出生体重Z评分较低相关（校正差异为-0.31 [95% C.I. -0.61至-0.01]，p = 0.04）。总之，这项研究表明，在预先存在心功能不全的妇女中，早产先兆子痫的发病率适度增加，FGR显著增加。我们的研究结果不一定支持心功能不全和先兆子痫之间的因果关系，特别是考虑到人群的背景风险状态。心功能不全和FGR之间关系的机制值得进一步研究，但可能受到同时使用β受体阻滞剂的影响。
Pre-eclampsia is associated with postnatal cardiac dysfunction; however, the nature of this relationship remains uncertain. This multicentre retrospective cohort study aimed to determine the prevalence of pre-eclampsia in women with pre-existing cardiac dysfunction (left ventricular ejection fraction < 55%) and explore the relationship between pregnancy outcome and pre-pregnancy cardiac phenotype. In this cohort of 282 pregnancies, pre-eclampsia prevalence was not significantly increased (4.6% [95% C.I 2.2–7.0%] vs. population prevalence of 4.6% [95% C.I. 2.7–8.2], p = 0.99); 12/13 women had concurrent obstetric/medical risk factors for pre-eclampsia. The prevalence of preterm pre-eclampsia (< 37 weeks) and fetal growth restriction (FGR) was increased (1.8% vs. 0.7%, p = 0.03; 15.2% vs. 5.5%, p < 0.001, respectively). Neither systolic nor diastolic function correlated with pregnancy outcome. Antenatal ß blockers (n = 116) were associated with lower birthweight Z score (adjusted difference − 0.31 [95% C.I. − 0.61 to − 0.01], p = 0.04). To conclude, this study demonstrated a modest increase in preterm pre-eclampsia and significant increase in FGR in women with pre-existing cardiac dysfunction. Our results do not necessarily support a causal relationship between cardiac dysfunction and pre-eclampsia, especially given the population’s background risk status. The mechanism underpinning the relationship between cardiac dysfunction and FGR merits further research but could be influenced by concomitant ß blocker use.
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