Hypertension:孕早期血压高于130/80 mmHg有风险!上海4.7万孕妇研究称,易出现妊娠期糖尿病、早产和低出生体重儿

2020-02-26 朱朱 中国循环杂志

根据美国目前最新的高血压指南,血压处于130/80~<140/90 mmHg之间为1级高血压,中国称为正常血压高值。我国采取≥140/90 mmHg的高血压诊断标准,因此在美国1级高血压的定义,在我国尚属于正常血压范围。

根据美国目前最新的高血压指南,血压处于130/80~<140/90 mmHg之间为1级高血压,中国称为正常血压高值。我国采取≥140/90 mmHg的高血压诊断标准,因此在美国1级高血压的定义,在我国尚属于正常血压范围。

近期,上海交通大学医学院附属国际和平妇幼保健院黄荷凤等发表的一项大规模回顾性队列研究提示,在妊娠早期(20周以内)血压达到美国1级高血压标准的孕妇中,也就是血压超过了130/80 mmHg,妊娠期高血压、轻度和重度先兆子痫等妊娠期高血压疾病的发生风险均显着增加,怀孕前体重正常者尤其明显。



研究者发现,与血压正常的孕妇相比,妊娠早期血压处于130~134/80~84 mmHg以及135~139/85~90 mmHg的孕妇发生妊娠期高血压疾病的的风险均显着增加,分别增加1.34倍和2.05倍。

根据孕期体重指数分组后,研究者发现,在孕前体重指数正常(18.5~24.9 kg/m2)的孕妇中,孕早期血压处于130~134/80~84 mmHg以及135~139/85~90 mmHg者发生妊娠期高血压疾病的风险分别增加1.44倍和2.26倍。

而在孕前体重指数超重或肥胖(≥25 kg/m2)的孕妇中,上述两组1级高血压孕妇出现妊娠期高血压疾病的风险分别增加0.9倍和1.36倍。

与血压正常者相比,血压超过130/80 mmHg的孕妇中妊娠期糖尿病、早产和低出生体重儿(<2500 g)的发生率和风险均轻度升高。

天津武警后勤学院附属医院李玉明在本刊发文称,对于有妊娠期高血压疾病的女性,其心血管病风险起源于妊娠期,应该进行心血管病的一级预防。本研究则提示,妊娠早期血压超过了130/80 mmHg,也应该警惕,避免发生意外。

该研究一共纳入47 874名分娩单胎活产儿的孕妇,其中9048人妊娠早期的血压达到美国1级高血压标准。

原始出处:Dan-dan Wu, Ling Gao, Ou Huang, et al. Increased Adverse Pregnancy Outcomes Associated With Stage 1 Hypertension in a Low-Risk Cohort: Evidence From 47 874 Cases. Hypertension, 2020, 75: 772–780.

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    2020-07-02 feather89
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  5. 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  6. 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  7. 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    2020-02-26 misszhang

    谢谢MedSci提供最新的资讯

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