Mild gestational hypertension remote from term: Progression and outcome
Mild gestational hypertension remote from term: Progression and outcome
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DOI：
10.1067/mob.2001.112905
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发表时间：
2001-04-01
影响因子：
9.8
通讯作者：
Sibai, BM
中科院分区：
文献类型：
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作者：
Barton, JR;O'Brien, JM;Sibai, BM
目的：关于轻度妊娠期高血压妇女疾病进展的信息有限。我们的目的是描述轻度妊娠期高血压和妊娠结局的妇女谁是远程长期轻度妊娠期高血压，是expectoredmanaged.Study设计：轻度妊娠期高血压参与门诊高血压监测计划的妇女的自然过程中的预后迹象进行了研究。入选标准为妊娠24 - 35周的单胎妊娠患者，在参与计划的前2天，试纸检测无蛋白尿（0或微量）。进展为先兆子痫是主要结局。重度子痫前期的进展率、产科并发症和新生儿结局是次要指标。数据进行了比较，独立的学生t和Fisher精确testswhereapplicable.RESULTS：在观察期间，共748例患者进行了研究，先兆子痫（持续性蛋白尿大于或等于1+）开发343（46%），和72（9.6%）有产前进展为重度先兆子痫。在发生持续性蛋白尿的妇女和未发生持续性蛋白尿的妇女之间，没有观察到母亲年龄、种族、婚姻状况或烟草使用的显著差异。分娩时婴儿的年龄（36.5 +/- 2.4 vs 37.4 +/- 2.0周），出生体重（2752 +/- 767 vs 3038 +/- 715 g），小于胎龄新生儿的发生率（24.8% vs 13.8%），以及新生儿住院时间（7.1 +/- 10 vs 5.0 +/- 9.3天）在有蛋白尿的患者与无蛋白尿的患者之间存在显著差异结论：在轻度妊娠期高血压患者中，46%的患者最终发生先兆子痫，9.6%的患者进展为重度疾病。蛋白尿的发生与分娩时胎龄较早、出生体重较低和小于胎龄儿发生率增加有关。
OBJECTIVE: Limited information is available regarding the progression of disease in women with mild gestational hypertension. Our purpose was to describe the prognostic signs in the natural course of mild gestational hypertension and pregnancy outcomes in women who were remote from term with mild gestational hypertension that was expectantly managed.STUDY DESIGN: Women with mild gestational hypertension participating in an outpatient hypertension monitoring program were studied. Inclusion criteria were patients with a singleton pregnancy between 24 and 35 weeks' gestation who had no proteinuria by dipstick (0 or trace) on the first 2 days of program participation. Progression to preeclampsia was the primary outcome. The rate of progression to severe preeclampsia, obstetric complications, and neonatal outcomes were secondary measures. Data were compared by independent Student t and Fisher exact tests where applicable.RESULTS: A total of 748 patients were studied during the observation period; preeclampsia (persistent proteinuria greater than or equal to1+) developed in 343 (46%), and 72 (9.6%) had antepartum progression to severe preeclampsia. No significant differences in maternal age, race, marital status, or tobacco use were observed between those women in whom persistent proteinuria developed and those in whom it did not develop. Gestational age of the infants at delivery (36.5 +/- 2.4 vs 37.4 +/- 2.0 weeks), birth weight (2752 +/- 767 vs 3038 +/- 715 g), incidence of small-for-gestational-age newborns (24.8% vs 13.8%), and duration of neonatal hospital stay (7.1 +/- 10 vs 5.0 +/- 9.3 days) differed significantly in the patients with versus those without proteinuria (P < .001 for all).CONCLUSIONS: In patients with mild gestational hypertension remote from term, 46% ultimately had preeclampsia, with progression to severe disease in 9.6%. The development of proteinuria is associated with an earlier gestational age at delivery, lower birth weight, and an increased incidence of small-for-gestational age newborns.