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

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*

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

Objective: To explore the association between weight gain during the first half of pregnancy and the risk of hypertension disorder of pregnancy (HDP). Methods: This prospective cohort study recruited singleton pregnant women in the first trimester from November 2016 to March 2019 at 19 community hospitals in Tianjin. According to pre-pregnancy body mass index (BMI), the cohort was divided into 3 groups: underweight(BMI<18.5 kg/m²), normal-weight(18.5-24.9 kg/m²), and overweight/obese(≥25.0 kg/m²). The basic information of the participants was gathered through questionnaires, and the height, weight, and blood pressure of the participants were measured along with routine pregnancy examinations. The rate of gestational weight gain (rGWG) in the 3 periods (0-13⁺⁶, 14⁺⁰-20⁺⁶, and 0-20⁺⁶ weeks) of the participants was calculated. To observe the occurrence of HDP, the participants were followed up to 42 days postpartum. Using a generalized linear model, the association between rGWG at the 3 periods during the first half of pregnancy and HDP after 20 weeks of gestation was evaluated. Results: A total of 9 805 pregnant women were finally included, with the age of (30.6±3.8) years old, 9 418 (96.1%) Han ethnicity, and 6 845 (69.8%) primipara. There were 1 184 (12.1%), 6 831 (69.7%) and 1 790 (18.3%) participants in the underweight, normal-weight, and overweight/obese groups. Five hundreds and eight pregnant women were diagnosed with HDP (5.2%). The incidences of HDP were 1.8% (21/1 184), 3.9% (269/6 831), and 12.2% (218/1 790), respectively, in underweight, normal-weight, and overweight/obese groups. Adjusted for age, pre-pregnancy BMI, primipara, and family history of hypertension, women in the entire cohort with rGWG ≥ 0.18 kg/week before 13⁺⁶ weeks of pregnancy had a 28% higher HDP risk than those with rGWG ≤ 0.00 kg/week (RR=1.28, 95%CI 1.04-1.55, P=0.015), and the risk of HDP was increased by 39% in the overweight/obese group (RR=1.39, 95%CI 1.04-1.85, P=0.026), while no correlation was found between rGWG and HDP in underweight and normal-weight pregnant women (P>0.05). Weight gain during 14⁺⁰-20⁺⁶ weeks of pregnancy in any group was not related to the risk of HDP (P>0.05).In the entire cohort, compared to rGWG ≤0.14 kg/week, rGWG≥0.28 kg/week prior to 20⁺⁶ weeks increased HDP risk by 36% (RR=1.36, 95%CI 1.11-1.67, P=0.003). Normal-weight pregnant women with rGWG≥0.29 kg/week faced a 46% higher risk of HDP than those with rGWG≤0.15 kg/week (RR=1.46, 95%CI 1.11-1.93, P=0.008).In the overweight/obese group, excessive weight gain before 20⁺⁶ weeks seemed to increased risk of HDP, but the difference was not statistically significant (RR=1.35,95%CI 0.99-1.85, P=0.059), while the connection was nonexistent in underweight women. Conclusions: Except for pre-pregnancy underweight women, excessive weight gain during the first half of pregnancy is associated with increased risk of HDP among pregnant women.
Female ; Pregnancy ; Humans ; Infant, Newborn ; Adult ; Overweight/complications* ; Thinness/epidemiology* ; Prospective Studies ; Risk Factors ; Weight Gain ; Body Mass Index ; Obesity/complications* ; Hypertension, Pregnancy-Induced/etiology* ; Cohort Studies ; Pregnancy Complications

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

OBJECTIVETo study the effect of pregnancy-induced hypertension syndrome (PIH) on complications in very low birth weight (VLBW) preterm infants.

METHODSThe VLBW preterm infants were enrolled as research subjects, and according to the presence or absence of PIH in their mothers, they were divided into PIH group and non- PIH group. The incidence of major complications and length of hospital stay were compared between the two groups.

RESULTSThere were no significant differences between the two groups in gestational age, birth weight, sex, incidence rate of maternal diabetes, and use of antepartum hormone. The PIH group had a significantly higher rate of birth of small-for-gestational-age infants than the non-PIH group. The PIH group had a significantly lower incidence rate of bronchopulmonary dysplasia (BPD) than the non-PIH group, while there were no significant differences between the two groups in the incidence rates of apnea of prematurity, necrotizing enterocolitis, retinopathy of prematurity, and intraventricular hemorrhage-periventricular leukomalacia, and the length of hospital stay. There was no significant difference in the incidence rate of neonatal respiratory distress syndrome between the two groups, but the PIH group had a significantly lower proportion of infants who used pulmonary surfactant than the non-PIH group.

CONCLUSIONSPIH can alleviate respiratory complications and reduce the use of pulmonary surfactant and the incidence rate of BPD in preterm infants.

Bronchopulmonary Dysplasia ; epidemiology ; etiology ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Infant, Premature ; Infant, Very Low Birth Weight ; Pregnancy ; Pulmonary Surfactants ; therapeutic use ; Respiratory Distress Syndrome, Newborn ; epidemiology

OBJECTIVETo understand the relationship between perinatal factors and congenital hypothyroidism (CH) and provide scientific evidence for the prevention of CH.

METHODSA case-control study was conducted among 125 neonates with CH (case group) and 375 neonates without CH (control group) in Fujian Neonatal Screening Center from January in 2012 to December in 2013. Univariate and multivariate logistic regression analysis were performed to identify the risk factors to CH during perinatal period.

RESULTSUnivariate logistic regression analysis indicated that compared with control group, gestational hypertension, gestational diabetes mellitus, gestational thyroid disease and older age of mother were the risk factors to CH, the difference was statistically significant (P < 0.05) and the risk of CH was higher in female babies, preterm babies, post-term babies low birth weight babies, macrosomia, twins, babies with birth defects and infection in cases group than those in control group, the difference was statistically significant (P < 0.05). Multivariate logistic analysis showed that older age of mother (OR = 2.518, 95% CI: 1.186-5.347), gestational diabetes mellitus (OR = 1.904, 95% CI: 1.190-3.045), gestational hypothyroidism or hyperthyroidism (OR = 12.883 and 30.797, 95% CI: 2.055-80.751 and 3.309-286.594), preterm birth (OR = 4.238, 95% CI: 1.269-14.155), and post-term birth (OR = 12.799, 95% CI: 1.257-130.327), low birth weight (OR = 3.505, 95% CI: 1.059-11.601), macrosomia (OR = 3.733, 95% CI: 1.415-9.851), twin or multiparous delivery (OR = 5.493, 95% CI: 1.701-17.735), birth defects (OR = 3.665, 95% CI: 1.604-8.371) and fetal distress (OR = 3.130, 95% CI: 1.317-7.440) were the high risk factors to CH (P < 0.05).

CONCLUSIONCH was correlated with mother's age, gestational diabetes, gestational thyroid disease as well as neonate's birth weight and gestational age, foetus number, fetal distress and other complicated birth defects at certain degree. More attention should be paid to perinatal care to reduce risk factors and the incidence of CH.

Birth Weight ; Case-Control Studies ; Congenital Hypothyroidism ; epidemiology ; Diabetes, Gestational ; epidemiology ; Female ; Gestational Age ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; Incidence ; Infant, Newborn ; Infant, Premature ; Maternal Age ; Neonatal Screening ; Pregnancy ; Pregnancy Complications ; epidemiology ; Premature Birth ; Risk Factors ; Twins

OBJECTIVETo investigate the impact of premature birth on long term cardio-cerebral vascular events of puerpera.

METHODSAmbispective cohort study method was used and 3 659 pregnant women giving birth during October 1976 to December 2008 at Kailuan medical group were included and divided into premature birth (PTB) group (n = 226) and non-PTB (NPTB) group (n = 3 433) by the history of PTB. 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 childbearing age, proportion of pregnancy-induced hypertension, systolic blood pressure and diastolic blood pressure before delivery were significantly higher while weight and height of newborn were significantly less in PTB group than in NPTB group (P < 0.05 or 0.01). (2) There were 71 cardio-cerebral vascular events during the follow-up of (15.19 ± 7.75) years. In PTB group, the incidence of cardio-cerebral vascular events and myocardial infarction was 3.23/1 000 person-years and 2.05/1 000 person-years, respectively, while the corresponding incidence was 1.15/1 000 person-years and 0.42/1 000 person-years, respectively in NPTB group (all P < 0.05). After adjustment for other traditional cardiovascular risk factors, the risk of total cardio-cerebral vascular events, myocardial infarction in PTB group was 2.03 fold (95% CI: 1.02-4.04, P = 0.002) and 3.11 fold (95% CI: 1.18-8.18, P < 0.001) higher than in NPTB group.

CONCLUSIONPTB is an independent risk factor for total cardio-cerebral vascular events, especially myocardial infarction of puerpera.

Blood Pressure ; Cardiovascular Diseases ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertension, Pregnancy-Induced ; Incidence ; Myocardial Infarction ; epidemiology ; Pregnancy ; Premature Birth ; Proportional Hazards Models ; Risk Factors ; Stroke

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 comprehend the epidemiological status and risk factors in hypertensive disorder complicating pregnancy (HDCP) in a district in Changsha, and to provide epidemiological evidence for early intervention of HDCP. METHODS: A total of 2 148 pregnant women in a district in Changsha from 2008 to 2009 were retrospectively analyzed and the related factors were evaluated by multivariate unconditional logistic analysis. RESULTS: The incidence of HDCP was 5.21% from 2008 to 2009. Multivariate unconditional logistic regression analysis showed that age (>35 years old)(OR=6.440,95%CI:2.987-13.884), body mass index (BMI) before pregnancy (OR=2.180,95%CI:1.619-2.936), and history of diabetes or kidney disease (OR=14.221,95%CI: 3.990-50.684) were risk factors for HDCP. CONCLUSION Age, BMI before pregnancy, and history of diabetes or kidney disease are risk factors for HDCP, while gravidity, parity, number of abortion and multiple gestation pregnancy have no obvious correlation with HDCP.
Adult ; Age Factors ; Body Mass Index ; China ; epidemiology ; Diabetes Mellitus ; Female ; Humans ; Hypertension, Pregnancy-Induced ; epidemiology ; etiology ; Incidence ; Logistic Models ; Multivariate Analysis ; Pregnancy ; Retrospective Studies ; Risk Factors