Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection
Hypertensive disorders in pregnancy and maternal and neonatal outcomes in Haiti: the importance of surveillance and data collection
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DOI：
10.1186/s12884-019-2361-0
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发表时间：
2019-06-20
影响因子：
3.1
通讯作者：
Pearce, Bradley
中科院分区：
文献类型：
--
作者：
Bridwell, Matthew;Handzel, Endang;Pearce, Bradley
背景这项研究旨在确定在海地选定的医院分娩的孕妇中报告的妊娠期高血压疾病(HDP)的患病率以及与这些疾病相关的孕产妇和新生儿结局。方法对2012年1月至2014年12月在海地各地不同科室的四家医院分娩的8822名单身新生儿进行了回顾。研究人员检查了报告患有HDP(高血压、先兆子痫、子痫)的妇女的比例，以及HDP妇女与三种新生儿结局：低出生体重、早产和死产；以及两种孕产妇结局：胎盘早剥和母亲死亡的相关性。结果在纳入研究的8822名单胎新生儿中，510名(5.8%)报告患有HDP(包括285名(55.9%)先兆子痫，119名(23.3%)子痫，106名(20.8%)高血压)。各医院HDP患病率依次为：HAS(13.5%)、HIC(3.2%)、自由堡(4.3%)和HSC(3.0%)。在患有HDP的HAS妇女中，调整后的低出生体重儿的风险是非HDP妇女的4倍(AOR 4.17，95%CI 3.19-5.45)，是死产的3倍多(AOR 3.51，95%CI 2.43-5.06)，以及导致孕产妇死亡的5倍(AOR 5.13，95%CI 1.53-17.25)。在三种类型的HDP中，子痫与不良事件的发生几率最大，是生下低出生体重儿的5倍(AOR 5.00，95%CI 2.84~8.79)，是死产的6倍(AOR 6.34，95%CI 3.40~11.82)，以及导致母亲死亡的12倍以上(AOR 12.70，95%CI 2.33~69.31)。在HAS中，HDP与母亲和新生儿不良结局的发生率较高相关，这与在高收入国家进行的HDP研究相当。
BackgroundThis study aims to determine reported prevalence of hypertensive disorders in pregnancy (HDP) and maternal and neonatal outcomes associated with these disorders among women delivering at selected hospitals across Haiti.MethodsA retrospective review of 8822 singleton deliveries between January 2012 and December 2014 was conducted at four hospitals in separate Departments across Haiti. Researchers examined the proportion of women with reported HDP (hypertension, preeclampsia, eclampsia) and the association between women with HDP and three neonatal outcomes: low birth weight, preterm birth, and stillbirths; and two maternal outcomes: placental abruption and maternal death in Hopital Albert Schweitzer (HAS). Odds ratios for associations between HDP and perinatal outcomes at HAS were assessed using logistic regression, adjusting for potential confounders.ResultsOf the 8822 singleton births included in the study, 510 (5.8%) had a reported HDP (including 285 (55.9%) preeclampsia, 119 (23.3%) eclampsia, and 106 (20.8%) hypertension). Prevalence of HDP among each hospital was: HAS (13.5%), Hopital Immaculee Conception des Cayes (HIC) (3.2%), Fort Liberte (4.3%), and Hopital Sacre Coeur de Milot (HSC) (3.0%). Among women at HAS with HDP, the adjusted odds of having a low birth weight baby was four times that of women without HDP (aOR 4.17, 95% CI 3.19-5.45), more than three times that for stillbirths (aOR 3.51, 95% CI 2.43-5.06), and five times as likely to result in maternal death (aOR 5.13, 95% CI 1.53-17.25). Among the three types of HDP, eclampsia was associated with the greatest odds of adverse events with five times the odds of having a low birth weight baby (aOR 5.00, 95% CI 2.84-8.79), six times the odds for stillbirths (aOR 6.34, 95% CI 3.40-11.82), and more than twelve times as likely to result in maternal death (aOR 12.70, 95% CI 2.33-69.31).ConclusionsA high prevalence of HDP was found among a cohort of Haitian mothers. HDP was associated with higher rates of adverse maternal and neonatal outcomes in HAS, which is comparable to studies of HDP conducted in high-income countries.