Hypertensive disease in pregnancy in Botswana: Prevalence and impact on perinatal outcomes
Hypertensive disease in pregnancy in Botswana: Prevalence and impact on perinatal outcomes
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DOI：
10.1016/j.preghy.2016.10.002
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发表时间：
2016-10-01
影响因子：
2.2
通讯作者：
Shapiro, Roger
中科院分区：
文献类型：
--
作者：
Johnson, Katherine M.;Zash, Rebecca;Shapiro, Roger
目的：撒哈拉以南非洲的围产期发病率被归因于感染、产科急诊和早产，但对妊娠高血压知之甚少。我们的目标是描述妊娠期高血压的患病率和高血压对围产期结局的影响在撒哈拉以南African.Study设计：我们进行了监测，在博茨瓦纳最大的公立医院的产科记录。如果妇女未感染艾滋病毒，有单胎妊娠和至少一个产前血压measurement.Main结果measurements：我们测量了死产，早产，小于胎龄儿，和新生儿死亡的妇女和没有高血压的pregnancy.Results：我们包括14,170孕妇。3156例（22.2%）女性发生高血压，其中602例（19.1%）被定义为重度高血压。重度高血压增加死产（RR 4.4; 95% CI 3.2-6.2）、早产（RR 2.5; 95% CI 2.2-2.8）、小于胎龄儿（RR 2.7; 95% CI 2.3-3.1）和新生儿死亡（RR 5.1; 95% CI 2.9-5.6）的风险。非重度高血压增加死产（RR 2.0; 95% CI 1.5-2.7）、早产（RR 1.2; 95% CI 1.1-1.3）和小于胎龄儿（RR 1.6; 95% CI 1.4-1.8）的风险。围产期结局更糟的妇女与高血压谁有自发性早产相比，那些谁接受医源性早产delivery.Conclusions：妊娠期高血压是常见的，在博茨瓦纳，并导致大量的不良后果。改善妊娠期高血压的管理可改善围产期发病率和死亡率。(C)2016年国际妊娠高血压研究学会。Elsevier B. V.出版，保留所有权利。
Objectives: Perinatal morbidity in sub-Saharan Africa has been attributed to infection, obstetric emergencies, and preterm birth, but less is known about hypertension in pregnancy. Our objective was to characterize the prevalence of hypertension in pregnancy and the impact of hypertension on perinatal outcomes in sub-Saharan Africa.Study design: We performed surveillance of obstetric records at eight of the largest public hospitals in Botswana. Women were included in this analysis if they were HIV-uninfected and had singleton gestations and at least one prenatal blood pressure measurement.Main outcome measures: We measured stillbirth, preterm birth, small for gestational age, and neonatal death in women with and without hypertension in pregnancy.Results: We included 14,170 pregnancies. Hypertension occurred in 3156 (22.2%) women, with 602 (19.1%) defined as severe. Severe hypertension increased risk of stillbirth (RR 4.4; 95% CI 3.2-6.2), preterm birth (RR 2.5; 95% CI 2.2-2.8), small for gestational age (RR 2.7; 95% CI 2.3-3.1) and neonatal death (RR 5.1; 95% CI 2.9-5.6). Non-severe hypertension increased risk of stillbirth (RR 2.0; 95% CI 1.5-2.7), preterm birth (RR 1.2; 95% CI 1.1-1.3), and small for gestational age (RR 1.6; 95% CI 1.4-1.8). Perinatal outcomes were worse in women with hypertension who had spontaneous preterm birth compared to those who underwent iatrogenic preterm delivery.Conclusions: Hypertension in pregnancy is common in Botswana and leads to a large number of adverse outcomes. Improved management of hypertension in pregnancy may improve perinatal morbidity and mortality. (C) 2016 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved.