Ischemic placental disease: epidemiology and risk factors
Ischemic placental disease: epidemiology and risk factors
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DOI：
10.1016/j.ejogrb.2011.07.025
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发表时间：
2011-11-01
影响因子：
2.6
通讯作者：
Vintzileos, Anthony M.
中科院分区：
文献类型：
--
作者：
Ananth, Cande V.;Vintzileos, Anthony M.
目的：先兆子痫、小于胎龄儿（SGA）和胎盘脱垂--构成“缺血性胎盘病”（IPD）综合征的病症--可能预示着共同的潜在病理生理学的不同临床表现。我们检查了（i）先兆子痫、SGA和妊娠合并症是否具有相似的风险特征;以及（ii）在足月妊娠和早产分娩的IPD患者之间是否存在这些特征的差异。我们利用了美国围产期合作项目的数据，这是一项多中心、前瞻性队列研究（1959-1966），仅限于单胎分娩>= 20周的妇女（n = 47，495）。我们比较了有和没有IPD以及先兆子痫的妇女之间的危险因素。结果：所有3种情况的危险因素有很强的重叠。社会经济阶层、收入、年龄、产次、教育、种族、BMI、婚姻状况和早产史在IPD妇女的早产和足月妊娠之间存在差异。虽然率先兆子痫，SGA和先兆子痫与SGA之间的期限和早产相似，其他条件的比率较高，在早产，妊娠是这些association.Conclusions背后的驱动条件：先兆子痫的类似风险配置文件。SGA和孕激素缺乏症提供了令人信服的证据表明，这些条件可能共享共同的病理生理机制缺血性胎盘疾病。早产儿的风险特征比足月儿的风险特征具有更大的同质性，这表明IPD可能是一种在早产妊娠中具有强大基础的综合征。(C)2011爱思唯尔爱尔兰有限公司保留所有权利。
Objective: Preeclampsia, small for gestational age (SGA) and placental abruption - conditions that constitute the syndrome of "ischemic placental disease" (IPD) - may portend different clinical manifestations of a common underlying pathophysiology. We examined if (i) preeclampsia, SGA and abruption share similar risk profiles: and (ii) if there are any differences in these profiles between patients with IPD that delivered at term and preterm gestations.Study design: We utilized data from the US Collaborative Perinatal Project, a multicenter, prospective cohort study (1959-1966), restricted to women that delivered singleton births at >= 20 weeks (n = 47,495.) We compared risk factors between women with and without IPD as well as preeclampsia. SGA and abruption.Results: A strong overlap in risk factors for all 3 conditions was evident. Socio-economic class, income, age, parity, education, race, BMI, marital status, and history of preterm birth were different between preterm and term gestations in women with IPD. Although rates of preeclampsia only, SGA only and preeclampsia with SGA were similar between term and preterm birth, rates of other conditions were higher at preterm gestations, with abruption being the driving condition behind these associations.Conclusions: The similar risk profiles for preeclampsia. SGA, and abruption provide compelling evidence to suggest that these conditions may share common pathophysiological mechanisms ischemic placental disease. Greater homogeneity in risk profiles within preterm than term births suggests that IPD may be a syndrome that has strong underpinnings at preterm gestations. (C) 2011 Elsevier Ireland Ltd. All rights reserved.