Postpartum change of blood pressure and its risk factors in patients with hypertensive disorders in pregnancy / 中南大学学报(医学版)

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.

Study on the influence of pregnancy-induced hypertension on neonatal birth weight and its interaction with other factors / 中华流行病学杂志

<p><b>OBJECTIVE</b>To research the influence of pregnancy-induced hypertension (PIH) on neonatal birth weight and its interaction with other factors.</p><p><b>METHODS</b>A retrospective cohort study was conducted in this study. 14 townships were randomly selected by cluster random sampling method from 37 townships in Liuyang city, Hunan province. All pregnant women from these 14 townships with pregnancy care manual and delivery record, during April 1st, 2008 to March 31st, 2011 were selected as subjects of this study. Blood pressure during pregnancy and neonatal birth weight were recorded. Multinomial logistic regression model was used to adjust the confounding factors. Addictive effects model was used for interaction analysis.</p><p><b>RESULTS</b>Data from 6 102 subjects were collected, including 418 (6.9%) pregnant women with PIH, 166 (2.7%) infants with low birth weight and 333 (5.5%) with fetal macrosomia. Results from the Multinomial logistic regression analysis showed significant association between neonatal birth weight and PIH, premature birth, BMI <18.5 before pregnancy, and weight gain ≥ 16 kg during pregnancy. Data from the Interaction analysis showed that there was strong positive interactions between PIH and premature birth to low birth weight infants (RERI = 35.08, API = 0.435, S = 1.7), and between PIH and BMI<18.5 before pregnancy to low birth weight infants. However, no significant interaction was found between PIH and weight gain.</p><p><b>CONCLUSION</b>Factors as PIH, premature birth, BMI before pregnancy and weight gain showed impact on low birth weight or fetal macrosomia. PIH also showed significant interaction on neonatal birth weight with premature birth as well as BMI before pregnancy, respectively.</p>

A population based study on incidence and determinants of preterm birth in Liuyang Hunan / 中南大学学报(医学版)

OBJECTIVE@#To describe the incidence and to discuss the risk factors of premature birth in rural areas of Liuyang.@*METHODS@#We collected subjects from villages and towns in Liuyang through cluster sampling method. Before enrolling in this cohort, all of them had established health records from January 2010 to December 2011. We followed up the early, middle and late stages of pregnancy until delivery, and collected medical records and maternal health care manual of this cohort as our data materials. We explored the main influence factors of premature delivery by χ2 test and unconditional logistic regression analysis for single factor and multivariate analysis.@*RESULTS@#Among 6270 women who enrolled in our cohort, 259 were diagnosed as premature birth. The incidence (4.13%) was lower than the national average level. Non-conditional logistic regression analysis showed that the risk factors of premature birth were as follows: OR of placental abruption was 7.678 (95% CI: 2.249-26.215), that of premature rupture of fetal membranes (PROM) was 5.177 (95% CI: 3.945-6.793), that of uterine abnormal and deformity was 2.675 (95% CI: 1.007-7.107), that of placenta anomaly was 2.633 (95% CI: 1.666-4.162), that of hypertension in pregnancy was 2.172 (95% CI: 1.044-4.521), that of pregnancy complications was 1.806 (95% CI: 1.033-3.157), that of male fetus was 1.429 (95% CI: 1.086-1.881). Protective factors of preterm birth were too frequent prenatal examination (OR=0.502, 95% CI: 1.033-3.157) and single pregnancy (OR=0.155, 95% CI: 0.075-0.319).@*CONCLUSION@#Preterm delivery is caused by complicated factors, such as placental abruption, PROM and male fetus. Comprehensive measures should be taken to reduce preterm birth.