Effects of interpregnancy interval on blood pressure in consecutive pregnancies
Effects of interpregnancy interval on blood pressure in consecutive pregnancies
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DOI：
10.1093/aje/kwn115
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发表时间：
2008-08-15
影响因子：
5
通讯作者：
Grewal, Jagteshwar
中科院分区：
文献类型：
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作者：
Mikolajczyk, Rafael T.;Zhang, Jun;Grewal, Jagteshwar
在经产妇女中观察到的先兆子痫风险较低，这促使人们提出一种假设，即第一次怀孕后的心血管适应具有持续的益处，有助于降低第二次怀孕时先兆子痫的风险。然而，妊娠间隔如何影响平均动脉压（MAP）作为后续妊娠心血管适应的指标尚未得到充分研究。作者使用围产期协作项目 (1959-1965) 的数据和半参数随机效应回归模型，研究了连续妊娠中妊娠间隔对 MAP 的影响。对 533 名第一胎和第二胎的妇女进行了产前 MAP 测量。对于非常短的妊娠间隔，第二次妊娠时的 MAP 较低（约 2 mmHg）。然而，当间隔增加时，这种差异就会减小，并且当间隔超过 2 年时，这种差异完全消失。作者得出的结论是，尽管第二次妊娠时的 MAP 低于第一次妊娠，但这种影响仅持续很短的时间。因此，涉及 MAP 作为心血管适应指标的机制不太可能明显有助于降低随后妊娠中先兆子痫的风险。然而，并不排除其他心血管适应机制持续更长时间的可能性。
The lower risk of preeclampsia observed in parous women has prompted a hypothesis that cardiovascular adaptation from a first pregnancy has ongoing benefits which contribute to a reduced risk of preeclampsia in the second pregnancy. However, how the interpregnancy interval affects mean arterial pressure (MAP) as an indicator of cardiovascular adaptation in subsequent pregnancies has not been well studied. The authors examined the effect of interpregnancy interval on MAP in consecutive pregnancies using data from the Collaborative Perinatal Project (1959-1965) and a semiparametric random-effects regression model. Prenatal MAP measurements were available for 533 women with both first and second births. MAP was lower in the second pregnancy (by approximately 2 mmHg) for very short interpregnancy intervals. However, this difference diminished when the interval increased, and it totally disappeared for intervals longer than 2 years. The authors conclude that although MAP is lower in the second pregnancy than in the first pregnancy, the effect persists for only a short time. It is therefore unlikely that mechanisms involving MAP as an indicator of cardiovascular adaptation contribute appreciably to the reduced risk of preeclampsia in subsequent pregnancies. However, it does not rule out the possibility that other mechanisms of cardiovascular adaptation persist longer.