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Associations of systolic blood pressure trajectories during pregnancy and risk of adverse perinatal outcomes
Hypertension Research ( IF 4.3 ) Pub Date : 2019-11-05 , DOI: 10.1038/s41440-019-0350-3
Qianlan Guo 1 , Pei Feng 2 , Qian Yu 2 , Wei Zhu 2 , Hao Hu 1 , Xin Chen 1 , Hongmei Li 1, 3
Affiliation  

This study aimed to explore the association of systolic blood pressure (SBP) trajectories of pregnant women with the risk of adverse outcomes of pregnant women and their fetuses. A register-based cohort of 63,724 pregnant women and their fetuses from January 2013 to December 2017 was investigated. Demographic characteristics, history of disease and family history of disease for pregnant women and perinatal outcomes were recorded, and blood pressure was measured during the whole pregnancy. SBP trajectories were estimated with latent mixture modeling by Proc Traj in SAS using SBP data from the first antenatal care appointment (8–14 weeks), the highest SBP before admission, the admission SBP and the SBP at 2 h postpartum. A censored normal model (CNORM) was considered appropriate, and model fit was assessed using the Bayesian information criterion (BIC). A logistic regression model was used to examine the association between SBP trajectories and the risk of adverse perinatal outcomes. Four distinct SBP trajectory patterns over the pregnancy period were identified and were labeled as low-stable, moderate-stable, high-decreasing and moderate-increasing. Three maternal and three fetal adverse outcomes were selected as the main outcome measures. After adjusting for confounding factors, compared with pregnant women with the low-stable pattern, those with the high-decreasing pattern had a higher risk of developing poor growth outcomes of fetuses, while those with the moderate-increasing pattern had higher risks of developing both adverse maternal and fetal outcomes. Our study results suggest that pregnant women should pay attention to the control of blood pressure throughout pregnancy.

中文翻译:

妊娠期收缩压轨迹与围产期不良结局风险的关联

本研究旨在探讨孕妇收缩压 (SBP) 轨迹与孕妇及其胎儿不良结局风险之间的关联。调查了 2013 年 1 月至 2017 年 12 月的 63,724 名孕妇及其胎儿的登记队列。记录人口学特征、孕妇疾病史和家族病史以及围产期结局,并在整个妊娠期间测量血压。SBP 轨迹由 SAS 中的 Proc Traj 使用潜在混合模型估计,使用来自第一次产前护理预约(8-14 周)的 SBP 数据、入院前最高 SBP、入院 SBP 和产后 2 小时的 SBP。删失正态模型 (CNORM) 被认为是合适的,并且使用贝叶斯信息标准(BIC)评估模型拟合。逻辑回归模型用于检查 SBP 轨迹与围产期不良结局风险之间的关联。确定了怀孕期间四种不同的 SBP 轨迹模式,并标记为低稳定、中稳定、高下降和中度上升。选择三个母体和三个胎儿的不良结局作为主要结局指标。调整混杂因素后,与低稳型孕妇相比,高降型孕妇发生胎儿生长不良结局的风险更高,而中升型孕妇发生两种情况的风险更高。不利的母婴结局。
更新日期:2019-11-05
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