The association of maternal chronic hypertension with perinatal death in male and female offspring:: a record linkage study of 866 188 women
The association of maternal chronic hypertension with perinatal death in male and female offspring:: a record linkage study of 866 188 women
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DOI：
10.1111/j.1471-0528.2008.01844.x
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发表时间：
2008-10-01
影响因子：
5.8
通讯作者：
Hanson, U.
中科院分区：
文献类型：
--
作者：
Zetterstrom, K.;Lindeberg, S. N.;Hanson, U.
目的本研究的目的是确定是否有差异，按性别，在围产期死亡率在慢性高血压妇女与血压正常women.Design人口为基础的前瞻性队列研究。设置瑞典。人口共866 188名妇女与单胎妊娠登记在瑞典医学出生登记1992-2004年，方法采用多因素Logistic回归分析。在第一步中，我们调整了母亲的特征，在第二步中，我们调整了轻度和重度先兆子痫、妊娠糖尿病、胎盘早剥和小于胎龄儿。结果胎儿宫内死亡的未校正OR为4.12，新生儿死亡的未校正OR为4.12，新生儿死亡的未校正OR为4.12（95% CI：2.84-5.96）和1.29（95%CI：0.67-2.48），新生儿死亡率为3.45（95% CI：2.13-5.59）和2.17（95% CI：1.08-4.35）。多因素分析后，男性胎儿宫内死亡的OR值为3.07（95%CI：2.12-4.46），新生儿死亡的OR值为2.99（95%CI：1.84-4.85）。女性子代宫内死亡的OR值为0.98（95%CI：0.51-1.89），新生儿死亡的OR值为1.88（95%CI：0.93-3.79）。
Objective The purpose of this study was to determine whether there is a difference, by gender, in perinatal mortality in chronically hypertensive women compared with normotensive women.Design Population-based prospective cohort study.Setting Sweden.Population A total of 866 188 women with singleton pregnancies registered in the Swedish Medical Birth Registry 1992-2004, of which 4749 were diagnosed with chronic hypertension.Methods Multivariate logistic regression analysis was performed. In a first step, we adjusted for maternal characteristics and in a second step for mild and severe pre-eclampsia, gestational diabetes, placental abruption and small for gestational age. An effect modification by gender was included in the model.Main outcome measures Odds ratios (OR) for intrauterine death, neonatal death and post-neonatal death with respect to gender of offspring.Results The unadjusted OR of intrauterine death was 4.12 (95% CI: 2.84-5.96) and 1.29 (95% CI: 0.67-2.48) for male and female offspring, respectively, and of neonatal death, it was 3.45 (95% CI: 2.13-5.59) and 2.17 (95% CI: 1.08-4.35) for male and female offspring, respectively. After multivariate analysis, the OR of intrauterine death was 3.07 (95% CI: 2.12-4.46) and neonatal death was 2.99 (95% CI: 1.84-4.85) for male offspring. For female offspring, the OR of intrauterine death was 0.98 (95% CI: 0.51-1.89) and neonatal death was 1.88 (95% CI: 0.93-3.79).Conclusion Mothers with chronic hypertension have an increased risk of perinatal mortality of their male offspring.