吉林省孕产妇妊娠期高血压疾病患病率及影响因素

姜停停; 万立新; 何欢; 易立岩

doi:10.16462/j.cnki.zhjbkz.2021.11.009

吉林省孕产妇妊娠期高血压疾病患病率及影响因素

doi: 10.16462/j.cnki.zhjbkz.2021.11.009

1.
130061 长春，吉林省妇幼保健院妇女群体保健科
2.
130061 长春，吉林省妇幼保健院
3.
长春，吉林大学公共卫生学院放射生物学教研室

基金项目:

中央财政转移支付地方卫生健康服务项目 Ji Cai She〔2019〕NO.474

详细信息

通讯作者:
易立岩，E-mail: 1350800724@qq.com

中图分类号: R181.1;R174
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- 被引次数: 0
出版历程
- 收稿日期: 2021-01-05
- 修回日期: 2021-03-09
- 网络出版日期: 2021-12-04
- 刊出日期: 2021-11-10

Analysis on prevalence and influencing factors of hypertensive disorder complicating pregnancy among pregnant women in Jilin Province

1.
Women's Group Health Section, Jilin Province Maternal and Child Health Hospital, Changchun 130061, China
2.
Jilin Province Maternal and Child Health Hospital, Changchun 130061, China
3.
Department of Radiobiology, School of Public Health, Jilin University, Changchun 130021, China

Funds:

National Maternal and Child Health Monitoring Project Ji Cai She〔2019〕NO.474

More Information

Corresponding author: YI Li-yan, E-mail: 1350800724@qq.com

摘要

摘要: 目的了解吉林省139 414例孕产妇妊娠期高血压疾病(hypertensive disorder complicating pregnancy, HDCP)患病率情况，分析其影响因素，为HDCP的预防和科学管理提供理论支持。方法采用横断面调查方法，利用以医院为基础的监测系统，收集全省13家监测医院2017年1月1日—2019年12月31日上报的≥20周分娩孕产妇作为研究对象。应用多因素Logistic回归分析模型探讨孕产妇HDCP的影响因素。结果本研究孕产妇患HDCP为6 400例，患病率为4.59%。其中患妊娠合并慢性高血压335例、妊娠期高血压1 959例、轻度子痫前期1 278例、重度子痫前期2 843例和子痫21例，患病率分别为0.24%、1.41%、0.92%、2.04%和0.02%。多因素非条件Logistic回归分析模型分析结果显示，年龄≥30岁、孕次≥2次、双胎/三胎的孕产妇与HDCP患病率升高有关；文化程度为高中/中专及以上、产次≥1次的孕产妇与HDCP患病率降低有关。结论吉林省孕产妇HDCP患病率低于全国平均水平，其中重度子痫前期患病率最高，建议继续加强基层医疗卫生机构对HDCP的识别和管理。
- 妊娠期高血压疾病 /
- 孕产妇 /
- 患病率 /
- 影响因素
Abstract: Objective Understanding the prevalence of hypertensive disorder complicating pregnancy (HDCP) among 139 414 pregnant women in Jilin Province and analyzing its influencing factors, to provide theoretical supports for the prevention and scientific management of HDCP. Methods Using the cross-sectional survey method, the hospital-based monitoring system was applied to selected the pregnant women who have delivered at 20 or more weeks in 13 monitoring hospitals in Jilin Province from January 1, 2017 to December 31, 2019, as the research subjects. Multivariate unconditional Logistic regression analysis was used to explore the influencing factors of HDCP in pregnant women. Results In this study, 6 400 cases of HDCP were diagnosed in pregnant women, with a prevalence rate of 4.59%. Among them, the prevalence of pregnancy complicated with chronic hypertension (335 cases), gestational hypertension (1 959 cases), mild preeclampsia (1 278 cases), severe preeclampsia (2 843 cases) and eclampsia (21 cases) was 0.24%, 1.41%, 0.92%, 2.04% and 0.02%, respectively. Multivariate unconditional Logistic regression analysis showed that pregnant women who aged 30 years and older, have two or more pregnancies, have been pregnant with twins/triplets were related to the increased prevalence of HDCP. Pregnant women who have high school/technical secondary school education level or higher and one parity or more were related to the decreased prevalence of HDCP. Conclusions The prevalence of HDCP among pregnant women in Jilin Province is lower than the national average level, among which the prevalence of severe preeclampsia is the highest. It is suggested to continue to strengthen the identification and management of HDCP in primary health care institutions.
- Hypertensive disorder complicating pregnancy /
- Pregnant women /
- Prevalence /
- Influencing factors

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表 1 吉林省2017—2019年孕产妇HDCP患病率

Table 1. The prevalence of HDCP in pregnant women from 2017 to 2019 in Jilin Province

年份 (年)	产妇数	慢性高血压合并妊娠		妊娠期高血压		轻度子痫前期		重度子痫前期		子痫
年份 (年)	产妇数	患病数	患病率(%)	患病数	患病率(%)	患病数	患病率(%)	患病数	患病率(%)	患病数	患病率(%)
2017	49 094	136	0.28	756	1.54	468	0.10	997	2.03	10	0.02
2018	42 938	118	0.27	608	1.42	376	0.09	929	2.16	6	0.01
2019	47 382	81	0.17	595	1.26	434	0.09	917	1.94	5	0.01
χ_趋势²		8.880		8.504		0.001		0.002		1.316
P值		0.003		0.004		0.974		0.960		0.251

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表 2 吉林省不同特征孕产妇HDCP患病率

Table 2. The prevalence of HDCP in pregnant women with different characteristics in Jilin Province

特征	产妇数	HDCP患病数	HDCP患病率(%)	χ²值	P值
年龄(岁)				418.987	＜0.001
0~＜25	17 563	747	4.25
25~＜30	62 486	2 414	3.86
30~＜35	41 965	1 932	4.60
≥35	17 400	1 307	7.51
文化程度				43.002	＜0.001
初中及以下	28 604	1 475	5.16
高中/中专	38 243	1 835	4.80
大学或以上(含大专)	72 567	3 090	4.26
婚姻状况				0.382	0.537
非在婚	668	34	5.09
在婚	138 746	6 366	4.59
孕次(次)				23.927	＜0.001
1	67 177	3 035	4.52
2	40 062	1 734	4.33
≥3	32 175	1 631	5.07
产次(次)				23.631	＜0.001
0	94 084	4 497	4.78
≥1	45 330	1 903	4.20
剖宫产史				0.147	0.701
无	118 749	5 462	4.60
有	20 665	938	4.54
胎儿数				367.255	＜0.001
单胎	137 578	6 145	4.47
双胎/三胎	1 836	255	13.89

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表 3 吉林省孕产妇HDCP多因素Logistic回归分析模型分析

Table 3. The multivariate Logistic regression analysis model of HDCP of pregnant women in Jilin Province

因素	β值	s_x	Wald值	OR(95%CI)值	P值
年龄(岁)
0~＜25				1.000
25~＜30	-0.023	0.043	0.274	0.978(0.898~1.064)	0.601
30~＜35	0.232	0.046	25.879	1.261(1.153~1.379)	< 0.001
≥35	0.825	0.051	262.382	2.283(2.066~2.523)	< 0.001
文化程度
初中及以下				1.000
高中/中专	-0.112	0.036	9.484	0.894(0.833~0.960)	0.002
大学或以上(含大专)	-0.273	0.034	65.877	0.761(0.712~0.813)	< 0.001
孕次(次)
1				1.000
2	0.070	0.035	3.978	1.072(1.001~1.149)	0.046
≥3	0.196	0.042	21.800	1.216(1.120~1.321)	< 0.001
产次(次)
0				1.000
≥1	-0.518	0.038	181.737	0.596(0.553~0.642)	< 0.001
胎儿数
单胎				1.000
双胎/三胎	1.186	0.069	292.310	3.273(2.857~3.750)	< 0.001

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表 4 吉林省不同年份孕产妇HDCP多因素Logistic回归分析模型分析

Table 4. The multivariate Logistic regression analysis of HDCP of pregnant women in different years in Jilin Province

年份(年)	因素	β值	s_x	Wald值	OR(95%CI)值	P值
2017	年龄(岁)
	0~＜25				1.000
	25~＜30	-0.033	0.068	0.238	0.967(0.846~1.106)	0.626
	30~＜35	0.169	0.074	5.220	1.184 (1.024~1.368)	0.022
	≥35	0.727	0.080	81.666	2.070(1.768~2.424)	< 0.001
	文化程度
	初中及以下				1.000
	高中/中专	0.006	0.057	0.013	1.006(0.901~1.125)	0.909
	大学或以上(含大专)	-0.263	0.055	22.995	0.769(0.691~0.856)	< 0.001
	孕次(次)
	1				1.000
	2	-0.166	0.053	9.734	0.847(0.764~0.940)	0.002
	≥3	-0.098	0.057	2.949	0.906(0.810~1.014)	0.086
	胎儿数
	单胎				1.000
	双胎/三胎	1.256	0.117	116.098	3.511(2.794~4.412)	< 0.001
2018	年龄(岁)				1.000
	0~＜25
	25~＜30	-0.040	0.077	0.273	0.961(0.826~1.117)	0.601
	30~＜35	0.219	0.081	7.356	1.245(1.063~1.458)	0.007
	≥35	0.877	0.089	97.783	2.403 (2.020~2.859)	< 0.001
	文化程度
	初中及以下				1.000
	高中/中专	-0.163	0.066	6.096	0.850(0.747~0.967)	0.014
	大学或以上(含大专)	-0.254	0.058	19.052	0.776(0.692~0.870)	< 0.001
	产次(次)
	0				1.000
	≥1	-0.398	0.054	54.323	0.672(0.604~0.747)	< 0.001
	胎儿数
	单胎				1.000
	双胎/三胎	1.178	0.118	99.051	3.249(2.576~4.098)	< 0.001
2019	年龄(岁)
	0~＜25				1.000
	25~＜30	-0.059	0.081	0.533	0.942 (0.804~1.105)	0.466
	30~＜35	0.217	0.083	6.847	1.242(1.056~1.462)	0.009
	≥35	0.718	0.093	59.299	2.050(1.708~2.461)	<0.001
	产次(次)
	0				1.000
	≥1	-0.420	0.055	58.131	0.657(0.590~0.732)	< 0.001
	胎儿数
	单胎				1.000
	双胎/三胎	1.131	0.126	80.987	3.100(2.423~3.966)	< 0.001

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