Pregnancy Outcome And The Risk Factors Of Superimposed Preeclampsia In Patients With Chronic Hypertension: A Study Of164Pregnancies In The First Affiliated Hospital Of Soochow University

Objective.To analysis effects of chronic hypertension in pregnancy on perinataloutcome, and to explore risk factors of superimposed preeclampsia in patients with chronichypertension.Methods.Indices of maternal and perinatal morbidity and mortality were determinedin164women with chronic hypertension who got regularly antenatal visit with dataprospectively collected and rigorously validated from October2011to November2013, theFirst Affiliated Hospital of Soochow University.The164women were divided into twogroups:chronic hypertention with and without preeclampsia(group PE，80cases,groupN-PE，84cases). Maternal and perinatal outcomes of the two groups and the high riskfactors for superimposed preeclampsia were analyzed.Results.(1) incidence of placenta abruption and postpartum hemorrhage in group PEwere higher than group N-PE（8.8%vs.1.2%，12.5%vs.2.4%；P＜0.05）.(2)Mediangestational age at delivery in group PE was small than group N-PE（35.3±4.1vs.38.1±2.4； P＜0.001）. the incidence of preterm birth before32,34,37weeks were18.8%,27.5%,35%,higher than group N-PE9.5%,2.4%,1.2%,respectively (p <0.001).(3)incidence of fetal growth restriction (small for gestational age) in group PE was higherthan group N-PE（33.7%vs.10.7%，P＜0.001）.(4) newborn intensive care unit(NICU)admission rate in group PE was higher higher than group N-PE（33.7%vs.10.7%，P＜0.001）.(5) The univariate analysis showed: age>35years, undergoing severe hypertensionbefore or in the first trimester of pregnancy,mean blood pressure over114mmHg in thefirst trimester of pregnancy,obesity and family history of chronic hypertension are high risk factors of superimposed preeclampsia in patients with chronic hypertension who gotregularly antenatal visit. The multivariate logistic regression analysis showed:undergoingmean blood pressure over114mmHg in the first trimester of pregnancy and obesity areindependent factors of superimposed preeclampsia in patients with chronic hypertensionwho got regularly antenatal visit.Conclusion. Maternal and perinatal morbidity and mortality are higher in patientswith superimposed preeclampsia than those patients without preeclampsia. undergoingmean blood pressure over114mmHg in the first trimester of pregna ncy and obesity areindependent factors of superimposed preeclampsia in patients with chronic hypertensionwho got regularly antenatal visi（tORs:7.018、2.656；95%CIs:2.684-18.354、1.045-6.749）.