育龄女性孕前血压水平与低出生体质量发生风险的相关性研究

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摘要目的分析育龄女性孕前血压水平与低出生体质量发生风险的关系。方法采用巢式病例对照研究的方法,将2013年参加国家免费孕前优生健康检查的育龄妇女纳入孕前队列,以随访期内生育单胎活产低出生体质量儿的10 872例女性作为病例组,从该队列中生育单活胎非低出生体质量儿中按1:4匹配随机抽取对照。采用多因素Logistic回归模型估计育龄女性孕前不同血压水平对低出生体质量发生风险的影响。结果经多因素调整后,与孕前收缩压＜120 mmHg者相比,收缩压水平在120～139、140～159 和≥160 mmHg者发生低出生体质量的OR值(95%CI)分别为1.16(1.09～1.25)、2.75(1.99～3.78) 和3.07(1.40～6.70)(趋势性检验P＜0.001);与孕前平均动脉压＜83.34 mmHg者相比,平均动脉压水平为83.34～93.33、93.34～103.33、103.34～113.33和≥113.34 mmHg者发生低出生体质量的OR值(95%CI)分别为1.08(1.01～1.15)、1.75(1.57～1.95)、2.69(1.99～3.63)和4.06(2.26～7.30)(趋势性检验P＜0.001);与正常血压者相比,正常高值、1级高血压、2级高血压者发生低出生体质量的OR值(95%CI)分别为1.12(1.05～1.19)、1.96(1.60～2.41) 和2.90(1.80～4.67)。结论育龄女性孕前血压水平与低出生体质量发生风险间存在显著的线性趋势关系。

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	杨英
	李谦
	彭左旗
	马旭

关键词 ：血压, 低出生体质量, 巢式病例对照研究, 孕前保健

Abstract：Objective To examine the relationship between preconception blood pressure (BP) and low birthweight (LBW) in a nested case-control study in Chinese reproductive-aged women. Methods A nested case-control study within a national maternal-infant cohort derived from the National Free Pre-pregnancy Checkups (NFPC) project in 2013 was conducted. From the cohort, 10 872 LBW cases were identified and 1:4 matched controls were randomly selected. Multivariate logistic regression models were used to estimate the odds ratios (OR) and 95% confidence intervals (CI) adjusted for potential confounding factors. Results Compared with the participants with a systolic BP (SBP) <120 mmHg, the adjusted OR (95%CI) of LBW was 1.16 (1.09-1.25), 2.75 (1.99-3.78) and 3.07 (1.40-6.70) for the participants with the SBPs of 120-139, 140-159 and ≥160 mmHg, respectively (P<0.001 for linear trend). Compared with the participants with a mean arterial pressure (MAP) <83.34 mmHg, the adjusted OR (95%CI) of LBW was 1.08 (1.01-1.15), 1.75 (1.57-1.95), 2.69 (1.99-3.63) and 4.06 (2.26-7.30) for the participants with MAPs of 83.34-93.33, 93.34-103.33, 103.34-113.33 and ≥113.34 mmHg, respectively (P<0.001 for linear trend). When the participants with normal BP were used as the reference, the adjusted OR (95%CI) of LBW was 1.12 (1.05-1.19), 1.96 (1.60-2.41) and 2.90 (1.80-4.67) for the participants with prehypertension, stage 1 hypertension and stage 2 hypertension, respectively. Conclusion These data indicated a strong linear, independent and positive association between preconception BP and the risk of LBW in Chinese reproductive-aged women.

Key words： Blood pressure Low birthweight Nested case-control study Preconception health care

收稿日期: 2015-06-10

基金资助:国家十二五科技支撑计划(2013BAI12B01);国家自然科学基金项目(81402757)

通讯作者: 马旭(maxutougao@163.com)

引用本文:

杨英, 李谦, 彭左旗, 马旭. 育龄女性孕前血压水平与低出生体质量发生风险的相关性研究[J]. 中国生育健康杂志, 2015, 26(6): 491-495.
YANG Ying, LI Qian, PENG Zuoqi, MA Xu. Preconception blood pressure and low birthweight: a nested case-control study. Chinese Journal of Reproductive Health, 2015, 26(6): 491-495.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2015/V26/I6/491

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