ABSTRACT
Objective:
To explore the influencing factors of
pregnancy-induced hypertensive disorders in
pregnancy (HDP) with organ or system impairment in
pregnant women, and to analyze and compare the differences of HDP subtypes in different regions of
China.
Methods:
A total of 27 680
pregnant women with HDP with complete data from 161
hospitals in 24 provinces, autonomous regions and municipalities were retrospectively collected from January 1, 2018 to December 31, 2018. According to their clinical manifestations, they were divided into
hypertension group [a total of 10 308 cases, including 8 250 cases of
gestational hypertension (GH), 2 058 cases of chronic
hypertension during
pregnancy] and
hypertension with organ or system impairment group [17 372 cases, including 14 590 cases of
pre-eclampsia (PE), 137 cases of
eclampsia, 2 645 cases of chronic
hypertension with PE]. The subtype distribution of HDP in East
China (6 136 cases), North
China (4 821 cases), Central
China (3 502 cases), South
China (8 371 cases), Northeast
China (1 456 cases), Southwest
China (2 158 cases) and Northwest
China (1 236 cases) were analyzed. By comparing the differences of HDP subtypes and related
risk factors in different regions, regional
analysis of the
risk factors of HDP
pregnant women with organ or system impairment was conducted.
Results:
(1) The proportions of HDP
pregnant women with organ or system impairment in Northeast
China (79.05%, 1 151/1 456), Central
China (68.42%, 2 396/3 502) and Northwest
China (69.34%, 857/1 236) were higher than the national average (62.76%, 17 372/27 680); the proportions in North
China (59.18%, 2 853/4 821), East
China (60.85%, 3 734/6 136) and South
China (59.56%, 4 986/8 371) were lower than the national average, and the differences were statistically significant (all P<0.05). (2) Univariate
analysis showed that the proportions of primiparas, non-Han, non-urban
household registration, irregular prenatal examination and PE
history in the
hypertension with organ or system impairment group were higher than those in the
hypertension group, and the differences were statistically significant (all P<0.05). Multivariate
logistic regression analysis showed that primiparas, non-Han, non-urban
household registration, irregular prenatal examination and PE
history were independent
risk factors for HDP
pregnant women with organ or system impairment (all P<0.05). (3) Primipara the rates of primipara in Northeast
China, North
China and Southwest
China were higher than the national average level, while those in South
China, Central
China and Northwest
China were lower than the national average level. Non-Han
nationality the rates of non-Han
nationality in Northeast
China, North
China and Northwest
China were higher than the national average, while those in East
China, South
China and Central
China were lower than the national average. Non-urban
household registration the rates of non-urban
household registration in Northeast
China, North
China, and Southwest
China were lower than the national average, while those in East
China, Central
China were higher than the national average. Irregular prenatal examination the rates of irregular prenatal examination in North
China, South
China and Southwest regions were lower than the national average level, while those in Northeast
China, Central
China and Northwest
China were higher than the national average level.
History of PE the
incidence rates of PE in Northeast
China, North
China, South
China and Southwest
China were lower than the national average level, while those in Central
China and Northwest
China were higher than the national average level.
Conclusions:
Primiparas, non-Han, non-urban
household registration, irregular prenatal examination, and PE
history are
risk factors for HDP
pregnant women with organ or system impairment.
Patients in Northeast, Central and Northwest
China have more
risk factors, and are more likely to be accompanied by organ or system function damage. It is important to strengthen the management of
pregnant women and reduce the occurrence of HDP.