Regional analysis of high risk factors of hypertensive disorders in pregnancy with organ or system impairment.
10.3760/cma.j.cn112141-20230218-00073
- Author:
Xin LYU
1
;
Wei Yuan ZHANG
2
;
Jing Xiao ZHANG
3
;
Yu Qian WEI
4
;
Xiao Li GUO
5
;
Shi Hong CUI
6
;
Jian Ying YAN
7
;
Xiao Yan ZHANG
8
;
Chong QIAO
9
;
Rong ZHOU
10
;
Wei Rong GU
11
;
Xian Xia CHEN
12
;
Zi YANG
13
;
Xiao Tian LI
11
;
Jian Hua LIN
1
Author Information
1. Department of Obstetrics and Gynecology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China.
2. Department of Obstetrics, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.
3. Department of Obstetrics and Gynecology, the Fourth Hospital of Shijiazhuang, Shijiazhuang 050035, China.
4. Department of Obstetrics and Gynecology, Affiliated Hospital of Jining Medical University, Jining 272007, China.
5. Department of Obstetrics, Changzhi Maternity and Child Health Care Hospital of Shanxi Province, Changzhi 046000, China.
6. Department of Obstetrics and Gynecology, the Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450015, China.
7. Department of Obstetrics, Fujian Maternity and Child Health Care Hospital, Fuzhou 350005, China.
8. Department of Obstetrics and Gynecology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China.
9. Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang 117004, China.
10. Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610044, China.
11. Department of Obstetrics, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200082, China.
12. Department of Obstetrics, Anhui Province Maternity and Child Health Hospital, Hefei 230001, China.
13. Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.
- Publication Type:Journal Article
- MeSH:
Humans;
Pregnancy;
Female;
Hypertension, Pregnancy-Induced/diagnosis*;
Retrospective Studies;
Pre-Eclampsia/epidemiology*;
Risk Factors;
Incidence
- From:
Chinese Journal of Obstetrics and Gynecology
2023;58(6):416-422
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the influencing factors of pregnancy-induced hypertensive disorders in pregnancy (HDP) with organ or system impairment in pregnant women, and to analyze and compare the differences of HDP subtypes in different regions of China. Methods: A total of 27 680 pregnant women with HDP with complete data from 161 hospitals in 24 provinces, autonomous regions and municipalities were retrospectively collected from January 1, 2018 to December 31, 2018. According to their clinical manifestations, they were divided into hypertension group [a total of 10 308 cases, including 8 250 cases of gestational hypertension (GH), 2 058 cases of chronic hypertension during pregnancy] and hypertension with organ or system impairment group [17 372 cases, including 14 590 cases of pre-eclampsia (PE), 137 cases of eclampsia, 2 645 cases of chronic hypertension with PE]. The subtype distribution of HDP in East China (6 136 cases), North China (4 821 cases), Central China (3 502 cases), South China (8 371 cases), Northeast China (1 456 cases), Southwest China (2 158 cases) and Northwest China (1 236 cases) were analyzed. By comparing the differences of HDP subtypes and related risk factors in different regions, regional analysis of the risk factors of HDP pregnant women with organ or system impairment was conducted. Results: (1) The proportions of HDP pregnant women with organ or system impairment in Northeast China (79.05%, 1 151/1 456), Central China (68.42%, 2 396/3 502) and Northwest China (69.34%, 857/1 236) were higher than the national average (62.76%, 17 372/27 680); the proportions in North China (59.18%, 2 853/4 821), East China (60.85%, 3 734/6 136) and South China (59.56%, 4 986/8 371) were lower than the national average, and the differences were statistically significant (all P<0.05). (2) Univariate analysis showed that the proportions of primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history in the hypertension with organ or system impairment group were higher than those in the hypertension group, and the differences were statistically significant (all P<0.05). Multivariate logistic regression analysis showed that primiparas, non-Han, non-urban household registration, irregular prenatal examination and PE history were independent risk factors for HDP pregnant women with organ or system impairment (all P<0.05). (3) Primipara: the rates of primipara in Northeast China, North China and Southwest China were higher than the national average level, while those in South China, Central China and Northwest China were lower than the national average level. Non-Han nationality: the rates of non-Han nationality in Northeast China, North China and Northwest China were higher than the national average, while those in East China, South China and Central China were lower than the national average. Non-urban household registration: the rates of non-urban household registration in Northeast China, North China, and Southwest China were lower than the national average, while those in East China, Central China were higher than the national average. Irregular prenatal examination: the rates of irregular prenatal examination in North China, South China and Southwest regions were lower than the national average level, while those in Northeast China, Central China and Northwest China were higher than the national average level. History of PE: the incidence rates of PE in Northeast China, North China, South China and Southwest China were lower than the national average level, while those in Central China and Northwest China were higher than the national average level. Conclusions: Primiparas, non-Han, non-urban household registration, irregular prenatal examination, and PE history are risk factors for HDP pregnant women with organ or system impairment. Patients in Northeast, Central and Northwest China have more risk factors, and are more likely to be accompanied by organ or system function damage. It is important to strengthen the management of pregnant women and reduce the occurrence of HDP.
