Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study.
Persistent Hypertension Up to One Year Postpartum among Women with Hypertensive Disorders in Pregnancy in a Low-Resource Setting: A Prospective Cohort Study.
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作者：
Ishaku SM;Jamilu T;Innocent AP;Gbenga KA;Lamaran D;Lawal O;Warren CE;Olorunfemi OO;Abubakar HD;Karima T;Patience OO;Musa A;Azubuike OK;Baffah AM;Franx A;Grobbee DE;Browne JL
妊娠期高血压疾病(HDP)与终生心血管疾病风险相关。持续的产后高血压可能提示进展为慢性高血压。这一现象在低收入和中等收入国家(LIMC)尚未得到很好的研究，以前的大多数随访通常最多持续产后六周。我们评估了在低资源环境下患有HDP的妇女中持续高血压的患病率，并确定了相关的危险因素。在尼日利亚七个州的八个三级卫生保健机构对妇女进行的前瞻性队列研究。在分娩后24小时内登记了410名患有任何产后发育迟缓的妇女，并每隔一段时间对其进行随访，直到产后一年。描述性统计被用来表达参与者的特征。进行单变量和多变量Logistic回归分析以确定相关的危险因素。在410名登记的妇女中，278人在分娩后一年内接受了随访(随访率为68%)。在诊断为妊娠期高血压和先兆子痫/子痫的妇女中，6个月时持续高血压的比例分别为22.3%(95%CI；8.3-36.3)和62.1%(95%CI；52.5-71.9)，1年后分别为22.3%(95%CI；5.6-54.4)和61.2%(95%CI；40.6-77.8)。孕妇年龄和体重指数是1年后持续高血压的显著危险因素[AORS=1.07/年(95%CI；1.02~1.13)和1.06/kg/m2(95%CI；1.01~1.10)]。这项研究表明，产后持续性高血压的患病率很高。需要组织LMICs的卫生系统，以预测和维持产后监测，直到血压恢复正常，或酌情将妇女转介或出院给家庭医生。特别是，应注意肥胖和/或产妇年龄较高的妇女。
Hypertensive disorders in pregnancy (HDPs) are associated with lifelong cardiovascular disease risk. Persistent postpartum hypertension in HDPs could suggest progression to chronic hypertension. This phenomenon has not been well examined in low- and middle-income countries (LIMCs), and most previous follow-ups typically last for maximally six weeks postpartum. We assessed the prevalence of persistent hypertension up to one year in women with HDPs in a low resource setting and determined associated risk factors. A prospective cohort study of women conducted at eight tertiary health care facilities in seven states of Nigeria. Four hundred and ten women with any HDP were enrolled within 24 hours of delivery and followed up at intervals until one year postpartum. Descriptive statistics were performed to express the participants’ characteristics. Univariable and multivariable logistic regressions were conducted to identify associated risk factors. Of the 410 women enrolled, 278 were followed up to one year after delivery (follow-up rate 68%). Among women diagnosed with gestational hypertension and pre-eclampsia/eclampsia, 22.3% (95% CI; 8.3–36.3) and 62.1% (95% CI; 52.5–71.9), respectively, had persistent hypertension at six months and this remained similar at one year 22.3% (95% CI; 5.6–54.4) and 61.2% (95% CI; 40.6–77.8). Maternal age and body mass index were significant risk factors for persistent hypertension at one year [aORs = 1.07/year (95% CI; 1.02–1.13) and 1.06/kg/m2 (95% CI; 1.01–1.10)], respectively. This study showed a substantial prevalence of persistent hypertension beyond puerperium. Health systems in LMICs need to be organized to anticipate and maintain postpartum monitoring until blood pressure is normalized, or women referred or discharged to family physicians as appropriate. In particular, attention should be given to women who are obese, and or of higher maternal age.
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影响因子：
1.6
作者：
Hwang JW;Park SJ;Oh SY;Chang SA;Lee SC;Park SW;Kim DK
通讯作者：
Kim DK
影响因子：
8.3
作者：
Meschia JF;Bushnell C;Boden-Albala B;Braun LT;Bravata DM;Chaturvedi S;Creager MA;Eckel RH;Elkind MS;Fornage M;Goldstein LB;Greenberg SM;Horvath SE;Iadecola C;Jauch EC;Moore WS;Wilson JA;American Heart Association Stroke Council;Council on Cardiovascular and Stroke Nursing;Council on Clinical Cardiology;Council on Functional Genomics and Translational Biology;Council on Hypertension
通讯作者：
Council on Hypertension
DOI：
10.1016/j.ijgo.2015.11.014
发表时间：
2016-07-01
影响因子：
3.8
作者：
Fadalallah, Zubaida M.;Elhassan, Elhassan M.;Adam, Ishag
通讯作者：
Adam, Ishag
影响因子：
8.3
作者：
Ditisheim, Agnes;Wuerzner, Gregoire;Pechere-Bertschi, Antoinette
通讯作者：
Pechere-Bertschi, Antoinette
影响因子：
15.8
作者：
Magee, Laura A.;Sharma, Sumedha;von Dadelszen, Peter
通讯作者：
von Dadelszen, Peter