Risk factors for preeclampsia in women with irregular prenatal care
10.3760/cma.j.issn.1007-9408.2015.06.007
- VernacularTitle:非规律产前检查孕妇子痫前期发病的影响因素
- Author:
Jialüe WANG
;
Zi YANG
;
Ying SONG
;
Yang CHEN
- Publication Type:Journal Article
- Keywords:
Pre-eclampsia;
Prenatal care
- From:
Chinese Journal of Perinatal Medicine
2015;18(6):425-429
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for severe and mild preeclampsia (PE) in women with irregular prenatal care,and to identify practical measures to reduce the occurrence of severe PE.Methods A retrospective study of 222 PE patients with irregular prenatal care,who delivered in Peking University Third Hospital from January 2007 to December 2011,was performed.The risk factors for PE and the status of prenatal care were analyzed.The non-parametric test,Chi-square test,Fisher's exact test,trendy Chi-square test and Logistic regression analysis were used for statistical analysis.Results There were 207 (93.2％) cases of severe PE and 15 (6.8％) cases of mild PE.In 207 severe PE patients,there were 95 cases (45.9％) of early-onset PE (diagnosed before 32 gestational weeks) and 112 cases (54.1％) of late-onset PE.In the 15 mild PE patients,there were two early-onset cases and 13 late-onset cases.The percentage of early-onset cases in severe PE patients was higher than that in mild PE patients [45.9％ (95/207) vs 2/15,x2=6.027,P=0.015].After excluding 9 cases without any prenatal care,213 PE patients were analyzed,and it was found that the proportion of severe PE diagnosed in hospitals of grade 3,2 and 1 were significantly different [5/9,94.2％ (131/139) vs 96.9％ (63/65),x2=8.600,P=0.003].Compared with mild PE patients,the prenatal care interval for PE diagnosis in severe PE patients was longer [M(Q),8.0(4.0) vs 4.8(4.4) weeks,Z=2.695,P=0.007];the frequency of prenatal care after 20 gestational weeks was less [1(1) vs 3(3) times,Z=-4.195,P=0.000];the gestational week of PE diagnosis and referral to grade 3 hospitals were earlier [32.4(5.6) vs 35.4(4.3) weeks,Z=-3.075,P=0.002;33.1(5.3) vs 35.4(3.9) weeks,respectively,Z=-2.608,P=0.009];and the interval between PE diagnosis and referral was longer [0.1 (0.7) vs 0.0(0.0) weeks,respectively,Z=2.904,P=0.004].Multivariate logistic regression showed that the frequency of prenatal care after 20 gestational weeks was an independent risk factor for severe PE (OR=0.115,95％CI:0.046-0.285,P=0.000).Conclusion In women without regular prenatal care,the onset of severe PE is related to low-level prenatal hospital care,lack of prenatal care after 20 gestational weeks and longer prenatal care intervals as well as referral to grade 3 hospitals.
