目的 探讨妊娠期高血压疾病对母儿结局的影响及发生高血压危象的相关影响因素.方法 选择100例妊娠期高血压疾病孕妇为研究对象,依据有无发生高血压危象分为对照组和观察组,每组50例.观察组发生高血压危象,对照组未发生高血压危象,比较两组临床指标、母婴结局及发生高血压危象的影响因素.结果 观察组剖宫产率、胎儿宫内窘迫率、早产率、新生儿黄疸率均高于对照组(P＜0.05);观察组新生儿1 min Apgar评分,产后24 h阴道出血量、终止妊娠孕周均优于对照组(P＜0.05);观察组收缩压、舒张压、脑钠肽(BNP)前体、乳酸脱氢酶(LDH)、肌酐水平均优于对照组(P＜0.05);两组年龄、体质量指数(BMI)、文化程度、孕次、产次、产检次数比较,差异均有统计学意义(P＜0.05);年龄≥35岁、建档BMI≥28 kg/m2、产次≤1次为妊娠期高血压疾病患者发生高血压危象的独立危险因素,文化程度为大学及以上、产检≥9次则为其保护因素(均P＜0.05).结论 妊娠期高血压危象孕妇母婴不良结局发生率高,适龄怀孕、重视产检、积极降压和控制并发症可以改善母婴结局.
Analysis of maternal and infant outcomes and influencing factors of hypertensive crisis during pregnancy
Objective To investigate the effects of hypertensive diseases during pregnancy on maternal and infant outcomes and the related factors of hypertensive crisis.Methods A total of 100 pregnant women with hypertensive diseases during pregnancy were selected as the study objects,and were divided into control group and observation group according to whether hypertension crisis occurred,with 50 cases in each group.Hypertensive crisis occurred in the observation group and did not occur in the control group.The clinical indexes,maternal and infant outcomes and influencing factors of hypertensive crisis were compared between the two groups.Results The cesarean section rate,fetal distress rate,premature delivery rate and neonatal jaundice rate in observation group were higher than those in control group(P＜0.05).1 min Apgar score,24 h postpartum vaginal bleeding and gestational weeks of termination of pregnancy in observation group were better than those in control group(P＜0.05).The levels of systolic blood pressure,diastolic blood pressure,BNP precursor,lactate dehydrogenase(LDH)and creatinine in observation group were better than those in control group(P＜0.05).There were significant differences in age,body mass index(BMI),education level,pregnancy time,delivery time and delivery test times between the two groups(P＜0.05).Age ≥ 35 years old,documented BMI≥28 kg/m2 and birth time ≤1 were independent risk factors for hypertensive crisis in patients with pregnancy-induced hypertension,education level of college or above and birth examination ≥9 times were protective factors(P＜0.05).Conclusion The incidence of adverse outcomes in pregnant women with hypertensive crisis during pregnancy is high.Age-appropriate pregnancy,prenatal examination,active hypotension and complication control can improve maternal and infant outcomes.
Hypertensive diseases during pregnancyHypertensive crisisPregnancy outcomeInfluencing factor
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