Pregnancy ; Female ; Humans ; Cardiovascular Diseases/epidemiology* ; Hypertension, Pregnancy-Induced ; Risk Factors ; Cardiovascular System ; Pre-Eclampsia

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.
Humans ; Pregnancy ; Female ; Hypertension, Pregnancy-Induced/diagnosis* ; Retrospective Studies ; Pre-Eclampsia/epidemiology* ; Risk Factors ; Incidence

OBJECTIVETo compare the incidence of cardio-cerebral vascular events between pregnancy induced hypertension (PIH) women and non-PIH(NPIH) women.

METHODSAmbispective cohort study method was used and 4630 pregnant women giving birth during October 1976 to December 2008 in our hospital and participated the healthy examination between July 2006 and October 2007 at Kailuan medical group were included and divided into PIH group (n = 694) and NPIH group (n = 3936) by the history of PIH. Incidence of cardio-cerebral vascular events (myocardial infarction, cerebral infarction and cerebral hemorrhage) was obtained during follow-up. Multivariable Cox proportional hazards regression models was used to assess the relative risk of cardio-cerebral vascular events.

RESULTS(1) The follow-up time was 2 to 34 (15.32 ± 7.94) years. (2) The childbearing age, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while gestational weeks and weight of newborn were significantly less in PIH group than in NPIH group (all P < 0.01). Levels of systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, triglyceride, total cholesterol and fasting blood glucose during healthy examination between July 2006 and October 2007 were significantly higher in PIH group than in NPIH group (P < 0.05 or P < 0.01). (3) There were 71 cardio-cerebral vascular events during the follow-up. In PIH group, the incidence rate of cardio-cerebral vascular events, myocardial infarction and cerebral infarction was 20.64%, 11.08% and 8.67%, respectively, while the corresponding incidence rate was 7.82%, 4.02% and 2.67% in NPIH group (all P < 0.01). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction and cerebral infarction in PIH group was 2.99 fold (95%CI: 1.80 - 4.95), 3.91 fold (95%CI: 1.71 - 8.91) and 3.96 fold (95%CI: 1.95 - 8.05) higher than in NPIH group.

CONCLUSIONPIH is an independent risk factor for cardio-cerebral vascular events.

Adult ; Cardiovascular Diseases ; epidemiology ; Case-Control Studies ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; Middle Aged ; Pregnancy ; Risk Factors

OBJECTIVETo explore the perpetual impact of pregnancy-induced hypertension on blood pressure.

METHODSThis retrospective cohort study included 782 cases of pregnant women who hospitalized at Kailuan Linxi hospital between October 1976 and August 2001. Patients were divided to with pregnancy induced hypertension (PIH, n = 77) group and non pregnancy induced hypertension (NPIH, n = 705) group. Patients were followed for 5 to 34 years (mean 18.8 +/- 5.3 years), the incidence of essential hypertension was obtained in July 2006-September 2007.

RESULTS(1) The cumulative incidence of essential hypertension during follow up was significantly high in PIH group (29.87%) than that in NPIH group 18.87% (P = 0.022). (2) At the final follow up, waist circumference; [(86.06 +/- 10.15) cm vs. (83.07 +/- 8.19) cm, P = 0.015], BMI [(24.83 +/- 4.01) kg/m(2) vs. (23.50 +/- 3.39) kg/m(2), P = 0.006], TC [(5.11 +/- 0.88) mmol/L vs. (4.89 +/- 0.94) mmol/L, P = 0.045] and GLU [(5.57 +/- 1.78) mmol/L vs. (5.20 +/- 1.38) mmol/L, P = 0.010] were all significantly higher in PIH group than those in NPIH group. (3) After adjustment of age and BMI, PIH was still significantly correlated with long-term systolic blood pressure levels (P = 0.048), fasting glucose level was also significantly associated with long-term systolic blood pressure. Age, BMI, white blood cell count and uric acid were also predictors for perpetual systolic and diastolic blood pressure levels.

CONCLUSIONSIncidence of essential hypertension in women with PIH was higher than that in women without PIH. After adjustment of covariates including age, BMI, and glucose, PIH was significantly associated with the level of systolic blood pressure. BMI, fasting glucose and cholesterol levels might contribute to the increase of systolic blood pressure in patients with PIH.

Adult ; Blood Pressure ; China ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; physiopathology ; Incidence ; Pregnancy ; Retrospective Studies ; Young Adult

OBJECTIVE: To compare maternal characteristics and pregnancy outcomes in a group of women with gestational diabetes mellitus(GDM) diagnosed in our hospital with those of women without this disorder. MATERIALS AND METHOD: This is a retrospective study of 402 gestational diabetic women with singleton cephalic presenting pregnancies delivered at Ilsin Christian Hospital during the period January 1, 1997, through December 31, 1999. National Diabetes Data Group thresholds were used to diagnose gestational diabetes. Women in this group were compared with a nondiabetic control group(n=430) randomly selected and effects of confounding variables were analyzed using stratified analysis. RESULTS: Prevalence of GDM was 2.36%. Women with gestational diabetes were significantly older, heavier, of greater parity and more often had the following risk factors for GDM. Hypertension, cesarean delivery, macrosomia, and large for gestational age(LGA) rate were significantly increased. The adequate treatment group diagnosed before 32wks and received glucose control was compared with a inadequate treatment group. And there was no significant difference in maternal characteristics and pregnancy outcomes between the two groups. Within the adequate treatment group, three groups were subdivided by birth weight as SGA(small for gestational age), AGA(appropriate for gestational age) and LGA. The group with LGA had no difference in age, parity, pregnancy-induced hypertension, 2hr mean postprandial glucose level except body mass index and insulin treatment rate. After adjusting these two factors with stratified analysis, there was no general association between birth weight and glucose level(p=0.342). CONCLUSIONS: Maternal characteristics of gestational diabetes were significantly different compared with those of nondiabetic women. Pregnancy outcomes of gestational diabetic women were not improved by our conventional management and more intensified but acceptable and compliable treatment should be tried.
Birth Weight ; Body Mass Index ; Confounding Factors (Epidemiology) ; Diabetes, Gestational* ; Female ; Glucose ; Humans ; Hypertension ; Hypertension, Pregnancy-Induced ; Insulin ; Parity ; Pregnancy ; Pregnancy Outcome* ; Pregnancy* ; Prevalence ; Retrospective Studies ; Risk Factors

Objective: To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). Methods: A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney U test, χ² test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. Results: (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m²) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both P<0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all P<0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all P>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both P<0.01). Conclusion: OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.
Infant, Newborn ; Pregnancy ; Infant ; Humans ; Female ; Pre-Eclampsia/epidemiology* ; Hypertension, Pregnancy-Induced/epidemiology* ; Retrospective Studies ; Premature Birth ; Sleep Apnea, Obstructive/epidemiology* ; Diabetes, Gestational/epidemiology*

OBJECTIVETo determine the association between pregnancy-induced hypertension(PIH) and risk of preterm delivery (PD) and low birth weight (LBW).

METHODSA prospective cohort was established based on 131 867 women who delivered a singleton baby in seven cities or counties in Zhejiang province, China, during the period of 1995 - 2000. The exposure group included 14 278 women who were diagnosed as PIH, and the non-exposure group included 117 589 women. The exposure group was divided into mild, moderate, and severe subgroups based on the severity of PIH, and further divided into early, medium and late onset subgroups based on the time of onset of PIH (occurred in second trimester, third trimester, or during delivery). The primary outcome measures were the incidence of PD and LBW. Multiple logistic regression was used to estimate relative risk and 95% confidence intervals after adjustment by maternal age, occupation, education, parity, number of prenatal visits, gestational disease, caesarean delivery, pregnant body mass index, fetal sex, and gestational age (only for LBW).

RESULTSThe incidence rates of PD and LBW in exposure group were 4.9% (701/14 278) and 3.6% (507/14 278), and both rates were higher than those of the non-exposure group (3.4% (4031/117 589), 1.8% (2110/117 589)) (chi(2) values were 80.8 and 202.0, P < 0.001). The incidence rates of PD in mild, moderate, and severe subgroups were 3.9% (404/10 358), 5.8% (181/3099), and 14.1% (116/821), and corresponding incidence rates of LBW were 2.5% (258/10 358), 4.9% (151/3099), and 11.9% (98/821). Both rates were increased with the severity of PIH (chi(2) values were 196.4 and 426.1, P-value for trend < 0.001). The incidence rates of PD in early, medium, and late onset subgroup were 8.4% (50/598), 5.7% (278/4867), and 4.2% (373/8813), and corresponding incidence rates of LBW were 5.7% (34/598), 4.2% (206/4867), and 3.0% (267/8813). Both rates were decreased by the time of PIH onset (chi(2) values were 115.4 and 239.8, P-value for trend < 0.001).

CONCLUSIONPIH could increase the incidence of PD and LBW.

Adult ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; Infant, Low Birth Weight ; Infant, Newborn ; Pregnancy ; Premature Birth ; Prospective Studies ; Young Adult

OBJECTIVETo examine the relationship between prepregnancy body mass index (BMI) and the risk of pregnancy-induced hypertension (PIH) in Chinese population.

METHODSData were collected in 6 counties/cities covered by Perinatal Health Care Surveillance System which was part of the Sino-American cooperative project on neural tube defects prevention established in 1992. The study population consisted of 83 159 women who attended premarital or preconception medical physical examination and delivered single live births with at least 20 gestational weeks from 1995 to 2000 in Jiaxing area. The Chi-square test was employed to test the difference in the rates of PIH among groups with different BMI. Multivariate logistic regression was conducted to examine the association between prepregnancy BMI and the risk of PIH.

RESULTSThe rate of PIH was 11.01% (9153/83 159; 95% CI: 10.79% - 11.22%). The rate of PIH among women with BMI < 18.5 kg/m(2), 18.5 - 22.9 kg/m(2), 23.0 - 24.9 kg/m(2), and > or = 25.0 kg/m(2) were 9.08% (1405/15 472; 95% CI: 8.63% - 9.54%), 10.82% (6389/59 054; 95% CI: 10.57% - 11.07%), 14.63% (943/6444; 95% CI: 13.78% - 15.52%), and 19.00% (416/2189; 95% CI: 17.38% - 20.71%), respectively, the difference was significant (chi(trend)(2) = 261.028, P = 0.000). Taking those with BMI 18.5 - 22.9 kg/m(2) as reference, the unadjusted RR for PIH was 0.82 (95% CI: 0.77 - 0.87) among women with BMI < 18.5 kg/m(2), 1.41 (95% CI: 1.31 - 1.52) among women with BMI 23.0 - 24.9 kg/m(2), and 1.93 (95% CI: 1.73 - 2.16) among women with BMI > or = 25.0 kg/m(2). After controlling for area, maternal age at delivery, educational level, occupation, parity, times of prenatal visit as well as the individual or family history of chronic hypertension, the estimated RR were 0.85 (95% CI: 0.80 - 0.90), 1.37 (95% CI: 1.27 - 1.47) and 1.88 (95% CI: 1.68 - 2.10), respectively.

CONCLUSIONHigh prepregnancy BMI could increase the risk of PIH.

Adult ; Body Mass Index ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; Incidence ; Logistic Models ; Pregnancy ; Rural Population ; Urban Population

OBJECTIVE: To investigate the change of blood pressure in patients with hypertensive disorders in pregnancy after delivery and the risk factors. METHODS: In a retrospective cohort study, we collected subjects from villages and towns in Liuyang by cluster sampling method. Before enrolling in this cohort, all had established health records from January 2010 to December 2011. We collected the medical records and maternal health care manuals of this cohort as our data materials, focusing on the blood pressure records as well as related features. We compared the differences of recovery rate of postpartum blood pressure in different kinds of antenatal blood pressure groups with χ2 test. In order to explore the main factors influencing the recovery rate of blood pressure of patients with hypertensive disorders in pregnancy, we conducted univariate and multivariate analysis by χ2 test and unconditional logistic regression analysis. RESULTS: Among the 460 women with hypertensive disorders in pregnancy in our analysis, the recovery rate of postpartum blood pressure reached 88.7%. Multivariate analysis showed that the risk factors influencing the recovery rate of postpartum blood pressure included advanced age (OR=0.436), higher degree of hypertensive disorders in pregnancy (OR=0.436), and hypertension with simultaneously high systolic and diastolic blood pressures (OR=0.192). CONCLUSION For most patients with hypertensive disorders in pregnancy, the blood pressure may decrease to normal level 42 days after delivery. Women with advanced age, higher degree of hypertensive disorders in pregnancy and hypertension with simultaneously high systolic and diastolic blood pressures should be given more attention.
Blood Pressure ; Diastole ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; physiopathology ; Postpartum Period ; Pregnancy ; Retrospective Studies ; Risk Factors ; Systole

Objective: To analyze the correlation between age and pregnancy-induced hypertension (PIH) in pregnant women from Hebei province in 2016. Methods: A retrospective analysis was conducted by using the clinical data of 64 909 pregnant women, delivering in 22 hospitals in Hebei in 2016. Descriptive statistics was used to describe the general data and pregnancy outcomes of pregnant women, and χ(2) test was used to compare the incidence of PIH in different age groups, and logistic regression analysis was used to analyze the risk factors for PIH. Results: The incidence of PIH was lowest in 20-29 year old women, and increased obviously in those aged<20 and>35 years (P<0.05), and the incidence was positively correlated with age. Logistic regression analysis showed that age, times of pregnancy, number of previous cesarean section and fetus number of current pregnancy were the risk factors for PIH (OR=1.293, 1.153, 1.307, 3.607), while times of deliver and times of prenatal examination were the protective factors (OR=0.655, 0.951). Conclusion: Advanced age pregnancy and young age pregnancy would significantly increase the incidence of PIH. Prenatal care should be strengthened for pregnant women at risk for PIH.
Adult ; Cesarean Section/statistics & numerical data* ; China/epidemiology* ; Female ; Humans ; Hypertension/complications* ; Hypertension, Pregnancy-Induced/ethnology* ; Incidence ; Maternal Age ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Young Adult