The Relationship Between The Level Of Blood Pressure In Pregnant Women And Hypertensive Disorders In Pregnancy And The Outcome Of Pregnancy

ObjectiveTo explore the relationship between blood pressure levels during early and middle gestational period and the risk of hypertensive disorders in pregnancy(HDP),and the influence of HDP during gestational period on gestational outcome.MethodsIn this study,women in early pregnancy were recruited from 10 community hospitals in Tianjin.The enrollment began on November 1,2016,and a total of2,306 patients were included.The included population was followed up until May 30,2018.First,in this study,the average systolic blood pressure(ASBP)and average diastolic blood pressure(ADBP)were measured at 12,16,20,24 and 28 weeks after pregnancy,and the occurrence of HDP was taken as the outcome event to analyze the correlation between the blood pressure level in early and middle pregnancy and HDP.Follow-up the above women in the study,the 174 cases of maternal HDP diagnosis and normal women as control,compared two groups of mothers adverse outcomes(maternal postpartum hemorrhage,placental abruption,premature rupture of membranes),two groups of cesarean section rate,preterm birth,poor perinatal outcomes(fetal distress and neonatal asphyxia,stillbirth)the incidence of and compare the two groups of neonatal weight levels and the incidence of low birth weight.Results1.A total of 2,189 pregnant women were included in this study.As of May30,2018,a total of 174 enrolled patients had developed HDP,with an incidence of 7.9%(95%CI 6.8-9.1%).2.With HDP as the dependent variable and average BP as the independent variable,when the average BP as the independent variable was included in the Logistic regression analysis according to the continuous variable,the blood pressure level in early and middle pregnancy affected the occurrence of HDP.For every 1mm Hg increase in SBP,the risk of HDP increased by 13.0%;for every 1mm Hg increase in DBP,the risk of HDP increased by 12.0%.Logistic regression analysis showed that the higher the blood pressure grading level was,the higher the risk of HDP was.In adjusting for confounding factors(white blood cell count,hemoglobin,check at the beginning of BMI,blood platelet count,ALT,total protein,albumin,fasting blood glucose levels and whether or not a first-time mother),higher SBP,each1 mm Hg,had a 10% increased risk of HDP,OR a value of 1.10(95%CI 1.07-1.12,P < 0.001),every increase 1 mm Hg DBP,had a 8% increased risk of HDP,OR a value of 1.08(95%CI 1.05-1.11,P < 0.001).The blood pressure was grouped by 10 mm Hg,and the OR values of SBP >120mm Hg,111-120 mm Hg,and 100-110 mm Hg were 26.87(95%CI 8.56-84.39),11.09(95%CI 3.75-32.81)and 6.50(95%CI 2.22-19.03),respectively,compared with the SBP<100mm Hg group.The OR values of DBP >80mm Hg,71-80 mm Hg and 60-70 mm Hg were 10.14(95%CI 2.12-48.57),5.19(95%CI 1.24-21.76)and3.21(95%CI 0.77-13.33),respectively,compared with the DBP<60mm Hg group.3.Cross combination of SBP and DBP after classification showed that the risk of HDP with SBP greater than 110 mm Hg and DBP greater than 70 mm Hg had an increased trend.4.The HDP group with adverse maternal outcomes(postpartum hemorrhage,placental abruption,premature rupture of membranes)was higher than the normal maternal group(P<0.05).The rate of cesarean section in HDP group was significantly higher than that in normal group(P<0.05).The incidence of perinatal adverse outcomes(intrauterine distress,neonatal asphyxia,stillbirth)in the HDP group was higher than that in the normal group(P<0.05),the incidence of preterm delivery was higher than that in the normal group(P<0.05),the neonatal weight was significantly lower than that in the normal group(P<0.05),and the incidence of low birth weight was higher than that in the normal group(P<0.05).Conclusion1.The conclusion of the study showed that ASBP and ADBP at 12 to 28 weeks of gestation were correlated with HDP,that is,the higher the maternal blood pressure level was,the greater the risk of HDP.2.Hypertensive diseases in pregnancy are harmful to mothers and infants in the short term.For pregnancy,the risk of placental abruption and premature rupture of membranes increased.It has adverse effects on the birth process of pregnant women,such as cesarean section rate and increased risk of postpartum hemorrhage.The risk of perinatal adverse outcome,premature delivery and low birth weight is high for fetal distress,neonatal asphyxia and stillbirth.