Hypertension Disorder In Pregnancy:Prediction And Risk For Adverse Pregnancy Outcomes

Part 1: Prediction of hypertension disorder complicating pregnancy Objective1.Observe the incidence of hypertension disorder complicating pregnancy(HDCP)and blood pressure change.2.Analysis the factors of HDCP in Guangxi birth cohort.3.Build prediction model of HDCP.MethodsIn multicenter cohort study,6203 women were recruited,2606 women who have blood pressure and urine routine examination were selected to analyses.Demographic characteristics,lifestyle,history of pregnancy,disease before pregnancy,medical using before pregnancy,and family history by investigation.Antenatal examination information,such as blood pressure and routine urine,were also collected.Binary logistic regressions were used to analyze the relationship between factors and HDCP.Prediction model were build base on the factors and were exanimated by ROC curve.20% random samples were used for further internal validation.ResultsOf 2606 subjects,173(6.64%)were HDCP.Age had positive corelation with HDCP(OR=1.04,95% CI:1.00-1.08).Primipara(OR=1.81,95% CI:1.23-2.66),irregular menstruation(OR=1.64,95% CI:1.13-2.39),were risk factors for HDCP.Systolic blood pressure before 20 gestational weeks were positively associated with HDCP(OR=1.06,95% CI:1.04-1.07).The prediction model combined maternal characteristic and systolic blood pressure before 20 gestational weeks was in a good coincidence(P>0.05),ROC area under the curve was 0.69(95% CI:0.65-0.73).Sensitivity and specificity were 78.4% and54.5%.ConclusionThe prediction model combined maternal characteristic and systolic blood pressure before 20 gestational weeks can predict HDCP.In the further research,sensitivity need to be improved.Part 2: The association of hypertension disorder complicating pregnancy and adverse birth outcomes.ObjectiveAnalyze the association of hypertension disorder complicating pregnancy and adverse birth outcomes,and further illustrate the necessity of prevention and prediction.Methods2606 women of part 1 were followed up after delivery,2489 were single birth.The information of deliver gestational age,birth weight,deliver way,still birth,birth defect,and Apgar score were collected.The incidence of adverse birth outcomes were compared between HDCP and normal blood pressure women.Logistics regressions were used to analyze the associations of HDCP and adverse birth outcomes.ResultsHDCP women who had increased significantly blood pressure(SBP≥150mmHg and/or DBP ≥95mmHg)had high risks for preterm birth and low birth weight(RR=2.69,95% CI:1.10-6.47;RR=2.81,95% CI:1.08-7.34),but had no significant relationship in deliver way,still birth,birth defect,and Apgar score.ConclusionHDCP with increased significantly blood pressure are associated with preterm and low birth weight,indicating that we should pay more attention onthe HDCP women with increased significantly blood pressure.