| Objective: To investigate the distribution of different types of hypertensive disorders in pregnancy(HDP),and the effects of different types of HDP on pregnancy outcomes and neonates,the clinical manifestations and the epidemiological characteristicsof pregnant women with HDP from a 3A grade hospital in Qiqihar city of Heilongjiang province in January 2014-June 2017 were analyzed.This study aimed to provide scientific basis for prevention and control of HDP in pregnancy,and for the protection of maternal and neonatal health.Methods: In January 2014 to June 2017,patients who were given birth and diagnosed with HDP in a 3A grade hospital in Qiqihar city were studied.The relevant clinical data of patients with HDP were collected,including age,parity,residence,disease history,mode of delivery,clinical symptoms and signs,laboratory tests,birth outcomes and neonatal delivery condition.Epi Data 3.2 database were used for data entry and verification,and SPSS 22.0 was adopted to analyze the data.The quantitative data are expressed as(SDx ±),and the qualitative data are expressed as a percentage or component ratio(%).t-test or variance analysis was used to analyze the statistical difference of the quantitative data,and chi-square test was used to analyze the statistical difference of qualitative data.P<0.05 was considered as statistically significant.Descriptive analysis,Logistic regression analysis and other statistical methods were used to obtain the epidemiological features of patients with HDP and to explore the influencing factors with HDP and neonatal adverse outcomes.Results: 1.The total detection rate of HDP in a 3A hospital in Qigihar,Heilongjiangprovince in January 2014-2017,was 5.78%.The highest detection rate was in the first half year of 2017(8.25%),and the lowest detection rate was in 2014(3.36%).In HDP classification,the detection rate of gestational hypertension was on the rise;the detection rate of preeclampsia in 2014-2016 was higher than that of other types of HDP;the detection rate of preeclampsia-eclampsia and chronic hypertension complicating with preeclampsia decreased in the first half year in 2017.2.The detection rate of HDP with GDM was 29.8%,HDP with HUA was 25.6%.HDP combined with GDM showed the highest incidence in preeclampsia-eclampsia.There was no statistically significant difference between different types of HDP(P=0.594).The incidence of HDP combined with HUA in preeclampsia-eclampsia was higher than that in other HDP groups,and the difference was statistically significant(P< 0.05).3.There was no statistically significant difference in the incidence of placental abruption in patients with different types of HDP(P=0.135).There were 2(1.9%)postpartum hemorrhage in patients with HDP.There was not statistically different in theincidence of postpartum bleeding between different types of HDP group(P=0.290).There were no cerebrovascular accidents,heart failure,renal failure and other birth outcomes in this study.4.The incidence of premature delivery in preeclampsia-eclampsia was the highest in the newborn outcomes of different types of HDP patients(22.8%),and the difference was statistically significant(P<0.05).The birth weight of gestational hypertension group was the heaviest(3294.63 ±633.96g),and the birth weight of preeclampsia-eclampsia group was the lowest(3090.39 ±720.56g).Compared with other types of HDP,patients with gestational hypertension had the longest gestational weeks(38.07±1.77)and the highest score of 1 minute Apgar evaluation(9.74±0.94).Gestational weeks in patients with chronic hypertension complicating with preeclampsia were the shortest(36.78 ±1.83);the lowest score of 1 minute Apgar evaluation was in the preeclampsia-eclampsia group(9.50±1.55),and the difference was statistically significant(P<0.001).5.The diastolic blood pressure in the diagnosis of HDP was the influencing factor of maternal adverse outcomes.The risk of adverse outcomes for every 1mm Hg raised by diastolic blood pressure was 1.078 times higher than that before the increase(95% CI 1.015~ 1.145).6.The incidence of gestational week,parity,systolic blood pressure and blood glucose are the risk factors of adverse neonatal outcomes.HDP mothers with more than 37 weeks of pregnancy were 0.034 times less likely to have a neonatal adverse outcome than those who had a pregnancy week<28 weeks(95%CI 0.007~0.161).The possibility of a neonatal adverse outcome in the HDP patients with the second or greater number of parities was 3.726 times than that in patients with lower than three times of parities(95%CI 1.101~12.615).The risk of neonatal adverse outcomes for every 1mm Hg raised by systolic blood pressure was 1.037 times higher than that before the increase(95%CI 1.002~1.073).The risk of neonatal adverse outcomes of patients that whose blood glucose were higher than 5.1mmol/L was 3.198 times higher than that whose blood glucose were lower than 5.1mmol/L(95%CI 1.372~7.455).Conclusion: 1.From 2014 to June 2017,the total detection rate of HDP in a 3A grade hospital in Qiqihar city of Heilongjiang province was 5.78%,lower than the domestic incidence of the disease(9.4%~10.4%).Among them,the detection rate of gestational hypertension was on the rise,and the detection rate of preeclampsia-eclampsia and chronic hypertension complicating with preeclampsia was decreasing.The proportion of preeclampsia-eclampsia was the highest(49.2%)in different types of HDP.2.The detection rate of GDM and HUA in HDP was 29.8% and 25.6% respectively.The detection rate was relatively high,indicating that the monitoring and management of patients with complications should be strengthened.3.The diastolic blood pressure in the diagnosis of HDP was the main influencing factor of the maternal adverse outcomes.4.The onset gestational age,parity,systolic blood pressure and blood glucose were the influencing factors of the neonatal adverse outcome. |
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