Abstract
王莎亚,周书进,文师吾,谭红专,罗美玲,郭亚伟,蔡畅,何玥,柳祎.正常妊娠前后血压变化及其影响因素研究[J].Chinese journal of Epidemiology,2013,34(3):241-244
正常妊娠前后血压变化及其影响因素研究
Changes in blood pressure and related determinants before and during normal pregnancy
Received:September 21, 2012  
DOI:
KeyWord: 妊娠  血压  体重指数  腰围
English Key Word: Pregnancy  Blood pressure  Body mass index  Waist circumference
FundProject:国家自然科学基金(30872167)
Author NameAffiliationE-mail
Wang Shaya School of Public Health, Central South University, Changsha 4l0008, China  
ZHOU Shujin School of Public Health, Central South University, Changsha 4l0008, China  
WEN ShiWU School of Public Health, Central South University, Changsha 4l0008, China  
TAN Hongzhuan School of Public Health, Central South University, Changsha 4l0008, China tanhz99@qq.com 
LUO Meiing School of Public Health, Central South University, Changsha 4l0008, China  
GUO Yawei School of Public Health, Central South University, Changsha 4l0008, China  
CAl Chang School of Public Health, Central South University, Changsha 4l0008, China  
HE Yue 湖南省浏阳市妇幼保健院  
LIU Yi 湖南省浏阳市妇幼保健院  
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Abstract:
      目的 了解正常妊娠前后妇女血压的变化特点及其影响因素.方法 采用前瞻性队列研究及整群随机抽样方法,从湖南省浏阳市37个乡镇随机抽取14个乡镇,以抽样乡镇2008年4月至2011年12月登记建册的所有育龄妇女为研究对象,在其首次婚前检查时进行面对面访问和填写调查问卷,随访观察时收集妊娠期间血压资料并追踪其妊娠结局.采用重复测量设计资料的方差分析探讨血压变化特点及其影响因素.结果 611名孕妇妊娠前后资料完整,其中排除41例妊娠期高血压者,共570名正常孕妇纳入研究.孕前、孕早期、孕中期、孕晚期SBP分别为(109.9±12.9)、(100.6±9.6)、(102.6±l0.1)、(107.8±10.9) mm Hg,DBP分别为(71.1±9.0)、(64.3±6.6)、(65.1±6.8)、(68.3±8.1) mmHg.重复测量资料的方差分析结果显示,孕后3个时期的血压均数均低于孕前,而孕晚期的血压均数高于孕早期和孕中期,差异有统计学意义.SBP和DBP在4个时间点的变化有统计学意义,同时变化趋势的线性拟合检验也有统计学意义.孕前BMI、孕前腰围和年人均经济收入对血压变化有影响.孕前BMI和腰围值大的孕妇孕期血压升高明显,而年人均经济收入主要影响孕前血压,对孕中后期血压无明显影响.结论 正常妊娠妇女孕期血压较孕前水平下降,而孕晚期血压高于孕早、中期.孕前BMI、腰围值和年人均经济收入是孕期血压的影响因素.
English Abstract:
      Objective To study the longitudinal changes of blood pressure (BP) and its related determinants before and during normal pregnancy.Methods 14 townships were randomly selected by cluster random sampling method from 37 townships in Liuyang city,Hunan province.Subjects are all women at childbearing age in these 14 townships registered from April 2008 to December 2011.When the subjects visited to the local maternity and child-care agencies for pre-marital check,they were face-to-face interviewed and asked to fill out the questionnaire and finish the medical examination.Following-up program was carried out until delivery,with BP and other pregnancy information checked and collected.Analysis on variance of data regarding repeated measurements were used to investigate the changes of BP and related determinants.Results A total of 611 cases with complete data were recruited,after excluding 41 cases who were diagnosed as pregnancy-induced hypertension.Finally,data on 570 healthy women with singleton pregnancies was analyzed.Systolic blood pressure (SBP) at pre-pregnancy,first trimester,second trimester and third trimester were (109.9 ± 12.9) mm Hg,(100.6 ± 9.6) mm Hg,(102.6 ± 10.1)mm Hg,(107.8 ± 10.9)nun Hg,respectively while the diastolic blood pressure (DBP) of pre-pregnancy,first trimester,second trimester and third trimester were (71.1 ± 9.0)mm Hg,(64.3 ± 6.6) mm Hg,(65.1 ± 6.8)mm Hg,(68.3 ± 8.1) mm Hg,respectively.The pre-pregnancy BP was lower than the three periods after pregnancy.BP of the third trimester was higher than that of the ones at first or second trimesters,with the difference statistically significant.SBP and DBP both indicated that there were statistically significant changes in the four periods and the linear trend test showed statistically significant.Pre-pregnancy BMI,pre-pregnancy waist circumference and annual per capita income were determinants which affecting the changes of BP.Higher pre-pregnancy body mass index (BMI),wider pre-pregnancy waist circumference and higher annual per capita income were associated with higher BP,while annual per capita income mainly affecting the pre-pregnancy BP.Conclusion BP of the three periods after pregnancy were lower than that of pre-pregnancy.BP of the third trimester was higher than both the first and second trimesters'.Pre-pregnancy BMI,pre-pregnancy waist circumference and annual per capita income were determinants which affecting the changes of BP.
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