Hypertensive disorders of pregnancy and stillbirth in North Carolina, 1988 to 1991
Hypertensive disorders of pregnancy and stillbirth in North Carolina, 1988 to 1991
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DOI：
10.3109/00016349509021198
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发表时间：
1995-11-01
影响因子：
4.3
通讯作者：
Bowes, WA
中科院分区：
文献类型：
--
作者：
Ananth, CV;Savitz, DA;Bowes, WA
背景。 The objectives of this study were (i) to assess the effect of hypertensive disorders of pregnancy on the risk of stillbirth, and (ii) to characterize the relationship between hypertension and stillbirth separately by gravidity, race, 'explained' Versus 'unexplained' causes of stillbirth, and antepartum versus intrapartum stillbirths.Method's.这项研究基于1988年至1991年之间通过出生和胎儿死亡证书确定的大约400,000次怀孕的回顾群体。使用与非高级母亲母亲的非高级母亲相比，使用多种逻辑比例的多变量logistic回归来比较高端风险，以比较高血压的风险。慢性高血压的风险分别为每1000例怀孕7.6，而怀孕诱发的高血压（PIH）和eClampsia的风险分别为每1000例怀孕36.6和6.0。慢性高血压的怀孕更有可能导致妊娠28周后损失（RR = 3.29，95％CI：2.43-4.43），而风险比为2.16（95％CI：1.45-3.22），损失28周之前。对PIH患者的妊娠在1.42（95％CI：1.15-1.79）终止死亡的风险更大，而Eclampsia的风险比为2.23（95％CI：1.51-3.30）。对于所有高血压疾病。发现高血压疾病对死产产生强烈的不利影响，这表明怀孕期间早期诊断出高血压和适当的医疗干预可能有助于降低死产的风险。
Background. The objectives of this study were (i) to assess the effect of hypertensive disorders of pregnancy on the risk of stillbirth, and (ii) to characterize the relationship between hypertension and stillbirth separately by gravidity, race, 'explained' Versus 'unexplained' causes of stillbirth, and antepartum versus intrapartum stillbirths.Method's. The study was based on a retrospective cohort of approximately 400,000 pregnancies identified through the birth and fetal death certificates in North Carolina, USA, between 1988 and 1991. Multivariable polytomous logistic regression was used to generate odds ratios comparing stillbirth risk in hypertensive compared to non-hypertensive mothers, adjusted for potential confounders.Results. The risk of chronic hypertension was 7.6 per 1000 pregnancies, while pregnancy-induced hypertension (PIH) and eclampsia were reported in 36.6 and 6.0 per 1000 pregnancies, respectively. Pregnancies among chronic hypertensives were more likely to result in losses after 28 weeks gestation (RR=3.29, 95% CI: 2.43-4.43), while the risk ratio was 2.16 (95% CI: 1.45-3.22) for losses prior to 28 weeks' gestation. Pregnancies to patients with PIH were at 1.42 (95% CI: 1.15-1.79) times greater risk of terminating in late stillbirth, while the risk ratio for eclampsia was 2.23 (95% CI: 1.51-3.30). The risk ratio for 'explained' antepartum stillbirth was higher than intrapartum stillbirth for all of the hypertensive diseases.Conclusions. Hypertensive disorders were found to have a strong adverse impact on stillbirth suggesting that early diagnosis of hypertension during pregnancy and adequate medical intervention may help reduce the risk of stillbirth.