Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997-2008.
Preeclampsia complicated by advanced maternal age: a registry-based study on primiparous women in Finland 1997-2008.
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DOI：
10.1186/1471-2393-12-47
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发表时间：
2012-06-11
影响因子：
3.1
通讯作者：
Heinonen S
中科院分区：
文献类型：
--
作者：
Lamminpää R;Vehviläinen-Julkunen K;Gissler M;Heinonen S
先兆子痫是一种常见的综合征，其原因与多种因素有关，使预防该综合征成为一项持续的挑战。先兆子痫的危险因素之一是高龄产妇。在西方国家，产妇首次分娩的年龄一直在稳步上升，但很少有研究探讨了高龄产妇与先兆子痫的妇女。这项基于登记的研究的目的是比较35岁以上和35岁以下的产妇和先兆子痫妇女的产科结局。这项基于登记的研究使用了三个芬兰健康登记处的数据：芬兰医疗出生登记处、芬兰医院出院登记处和先天性畸形登记处。样本包括35岁以下的妇女（N = 15，437），与1997年至2008年期间在芬兰被诊断患有先兆子痫并首次生育单胎的35岁及以上妇女（N = 2，387）相比。在多变量模型中，主要的结局指标是早产（34周和37周前），低Apgar评分（5分钟），小于胎龄儿、胎儿死亡、窒息、剖腹产、引产、输血和进入新生儿重症监护室。高龄产妇（AMA）的妇女表现出更多的先兆子痫（9.4%）比年轻的妇女（6.4%）。她们有更多的流产史（<0.001），更可能有>25的体重指数（<0.001），有更多的体外受精（<0.001）和其他生育治疗（<0.001），以及更高的母亲糖尿病（<0.001）和慢性高血压（<0.001）的发病率。多变量logistic回归分析表明，AMA女性的以下比率较高：37周前早产19.2%（OR 1.39 CI 1.24至1.56）和34周前8.7%（OR 1.68 CI 1.43 - 2.00）5分钟时Apgar评分低7.1%（OR 1.37 CI 1.00 - 1.88），小于胎龄儿（SGA）26.5%（OR 1.42 CI 1.28 - 1.57），窒息12.1%（OR 1.54 CI 1.34至1.77），剖腹产50%（OR 2.02 CI 1.84至2.20），入住新生儿重症监护室（NICU）31.6%（OR 1.45 CI 1.32至1.60）。先兆子痫在高龄产妇中更常见。高龄产妇是先兆子痫初产妇不良结局的独立危险因素。
Preeclampsia is a frequent syndrome and its cause has been linked to multiple factors, making prevention of the syndrome a continuous challenge. One of the suggested risk factors for preeclampsia is advanced maternal age. In the Western countries, maternal age at first delivery has been steadily increasing, yet few studies have examined women of advanced maternal age with preeclampsia. The purpose of this registry-based study was to compare the obstetric outcomes in primiparous and preeclamptic women younger and older than 35 years. The registry-based study used data from three Finnish health registries: Finnish Medical Birth Register, Finnish Hospital Discharge Register and Register of Congenital Malformations. The sample contained women under 35 years of age (N = 15,437) compared with those 35 and over (N = 2,387) who were diagnosed with preeclampsia and had their first singleton birth in Finland between 1997 and 2008. In multivariate modeling, the main outcome measures were Preterm delivery (before 34 and 37 weeks), low Apgar score (5 min.), small-for-gestational-age, fetal death, asphyxia, Cesarean delivery, induction, blood transfusion and admission to a Neonatal Intensive Care Unit. Women of advanced maternal age (AMA) exhibited more preeclampsia (9.4%) than younger women (6.4%). They had more prior terminations (<0.001), were more likely to have a body mass index (BMI) >25 (<0.001), had more in vitro fertilization (IVF) (<0.001) and other fertility treatments (<0.001) and a higher incidence of maternal diabetes (<0.001) and chronic hypertension (<0.001). Multivariate logistic regression indicated that women of AMA had higher rates of: preterm delivery before 37 weeks 19.2% (OR 1.39 CI 1.24 to 1.56) and before 34 weeks 8.7% (OR 1.68 CI 1.43 to 2.00) low Apgar scores at 5 min. 7.1% (OR 1.37 CI 1.00 to 1.88), Small-for-Gestational Age (SGA) 26.5% (OR 1.42 CI 1.28 to 1.57), Asphyxia 12.1% (OR 1.54 CI 1.34 to 1.77), Caesarean delivery 50% (OR 2.02 CI 1.84 to 2.20) and admission to a Neonatal Intensive Care Unit (NICU) 31.6% (OR 1.45 CI 1.32 to 1.60). Preeclampsia is more common in women with advanced maternal age. Advanced maternal age is an independent risk factor for adverse outcomes in first-time mothers with preeclampsia.
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影响因子：
7.2
作者：
Jacobsson, B;Ladfors, L;Milsom, I
通讯作者：
Milsom, I
影响因子：
6.1
作者：
Luke, Barbara;Brown, Morton B.
通讯作者：
Brown, Morton B.
影响因子：
2.5
作者：
Bayrampour, Hamideh;Heaman, Maureen
通讯作者：
Heaman, Maureen
影响因子：
1.4
作者：
Newburn-Cook, Christine V;Onyskiw, Judee E
通讯作者：
Onyskiw, Judee E
影响因子：
9.8
作者：
Villar, J;Carroli, G;Kramer, M
通讯作者：
Kramer, M