| 王颖,李玫,解冰洁,郭朋鸽,程雁鹏,冯永亮,张萍,邬惟为,王素萍,张亚玮,杨海澜.妊娠期高血压疾病对小于胎龄儿的影响及潜在交互作用研究[J].Chinese journal of Epidemiology,2016,37(9):1283-1287 |
| 妊娠期高血压疾病对小于胎龄儿的影响及潜在交互作用研究 |
| Influence of hypertension disorder complicating pregancy and its interaction with other factors on incidence of small for gestational age |
| Received:April 05, 2016 |
| DOI：10.3760/cma.j.issn.0254-6450.2016.09.020 |
| KeyWord: 妊娠期高血压疾病 小于胎龄儿 交互作用 |
| English Key Word: Hypertension disorder complicating pregancy Small for gestational age Interaction |
| FundProject:山西医科大学十人计划项目；山西省青年科技研究基金（2013021033-2）；山西省普通高校特色重点学科建设项目；国家自然科学基金（81473061） |
| Author Name | Affiliation | E-mail | | Wang Ying | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Li Mei | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Xie Bingjie | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Guo Pengge | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Cheng Yanpeng | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Feng Yongliang | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Zhang Ping | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Wu Weiwei | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | | | Wang Suping | Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan 030001, China | spwang88@163.com | | Zhang Yawei | Division of Environmental Health Sciences, School of Public Health, Yale University, USA | yawei.zhang@yale.edu.cn | | Yang Hailan | Obstetrics and Gynecology of First Affiliated Hospital, Shanxi Medical University, Taiyuan 030001, China | |
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| Abstract: |
| 目的 研究妊娠期高血压疾病对小于胎龄儿的影响及潜在交互作用。方法 采用巢式病例对照研究方法分析妊娠期高血压疾病对小于胎龄儿的影响，评价妊娠期高血压疾病与其他因素之间的交互作用；单因素分析采用χ2检验，多因素分析及相乘交互作用采用非条件logistic回归分析。结果 共收集单胎活产孕妇6 297例，其中妊娠期高血压疾病发生率为13.28%（836/6 297），小于胎龄儿发生率为12.53%（789/6 297）。与非妊娠期高血压疾病孕妇相比，妊娠期高血压孕妇（aOR=2.185，95% CI：1.266～3.770）、子痫前期/子痫孕妇（aOR=5.322，95% CI：4.224～6.707）及慢性高血压并发子痫前期孕妇（aOR=3.794，95% CI：2.190～6.573）发生小于胎龄儿的危险均明显升高。妊娠期高血压疾病与早产对小于胎龄儿的交互作用超额相对危险度（RERI）、交互作用归因比（AP）和交互作用指数（SI）分别为5.260、0.586和2.941，存在较为明显的相加交互作用及相乘交互作用（OR=2.331，95% CI：1.443～3.767）；妊娠期高血压疾病与胎盘早剥（RERI=5.631，AP=0.522，SI=2.352）、胎儿性别为女（RERI=3.660，AP=0.374，SI=1.714）、羊水偏少（RERI=10.619，AP=0.636，SI=3.093）均存在相加交互作用，未发现存在相乘交互作用。结论 妊娠期高血压疾病是发生小于胎龄儿的危险因素，且与胎盘早剥、胎儿性别为女、羊水偏少均存在相加交互作用，与早产存在相加及相乘交互作用。 |
| English Abstract: |
| Objective To understand the influence of hypertension disorder complicating pregancy on the incidence of small for gestational age (SGA) and its interaction with other factors. Methods A nested case-control study was conducted to analyze the influence of hypertension disorder complicating pregancy on the incidence of small for gestational age and evaluate the interaction between hypertension disorder complicating pregancy and other factors. Results Data from 6 297 subjects were collected, including 836 (13.28%) pregnant women with hypertension disorder complicating pregancy, 789 (12.53%) infants who were small for gestational age. Compared with the pregnant women without hypertension disorder complicating pregancy, women with hypertension disorder complicating pregancy (aOR=2.185, 95%CI:1.266-3.770), preeclampsia-eclampsia (aOR=5.322, 95%CI:4.224-6.707) and with chronic hypertension complicated with superimposed preeclampsia (aOR=3.794, 95%CI:2.190-6.573) had increased risk for the incidence of small for gestational age. The Interaction analysis showed that there was strong positive interactions between hypertension disorder complicating pregancy and premature birth on small for gestational age infants (RERI=5.260, AP=0.586, SI=2.941), (OR=2.331, 95%CI:1.443-3.767). Addictive interaction was found between hypertension disorder complicating pregancy and placental abruption (RERI=5.631, AP=0.522, SI=2.352), and between hypertension disorder complicating pregancy and female fetuses (RERI=3.660, AP=0.374, SI=1.714), and between hypertension disorder complicating pregancy and oligohydramnios (RERI=10.619, AP=0.636, SI=3.093). However, no significant multiplication interaction was found. Conclusions Hypertension disorder complicating pregancy is the risk factor of the incidence of small for gestational age. Hypertension disorder complicating pregancy also showed addictive interaction on the incidence of small for gestational age with female fetuses, placental abruption as well as oligohydramnios. There was addictive and multiplication interactions between hypertension disorder complicating pregancy and premature birth. |
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