Abstract：
OBJECTIVE: Determine clinical risk factors for vasculo-placental disorders in singleton pregnancies.
METHODS: Prospective case-control study nested in HEMOTHEPP French cohort.
METHODS: Women delivered between June, 2015 and January, 2019 in any maternity ward of Finistère.
METHODS: Cases were women with vasculo-placental disorders (pre-eclampsia, intrauterine growth restriction (IUGR), placental abruption or stillbirth). Controls were women matched for age at delivery and parity.
METHODS: Clinical data were collected by obstetricians or midwives during antenatal care visits and delivery, and recorded by trained research assistants.
METHODS: Occurrence of a vasculo-placental disorder.
RESULTS: 505 women with vasculo-placental disorder (299 pre-eclampsia, 253 IUGR, 44 placental abruptions, 11 stillbirths) and 1515 matched controls were selected out of 20,075 participants. In multivariable analysis, four clinical parameters were associated with pre-eclampsia: obesity (Odd ratio (OR) = 3.11, 95%CI 2.11-4.58), French overseas origin (OR = 4.41, 95%CI 1.87-10.42), previous vasculo-placental disorder (OR = 5.14, 95%CI 2.72-9.70), aspirin during pregnancy (OR = 10.10, 95%CI 1.99-51.08). Three clinical parameters were associated with IUGR: auto-immune/inflammatory disorder (OR = 3.75, 95%CI 1.83-7.68), previous vasculo-placental disorder (OR = 3.63, 95%CI 2.06-6.41), smoking during pregnancy (OR = 2.66, 95%CI 1.91- 3.71). A previous venous thromboembolism (VTE) was associated with IUGR in univariable but not in multivariable analysis (OR = 3.72, 95%CI 0.82-17.00, p = 0.09).
CONCLUSIONS: Clinical risk factors differ between IUGR and pre-eclampsia, the later, but not the former, being associated with cardiovascular risk factors.
METHODS: Prospective case-control study nested in HEMOTHEPP French cohort.
METHODS: Women delivered between June, 2015 and January, 2019 in any maternity ward of Finistère.
METHODS: Cases were women with vasculo-placental disorders (pre-eclampsia, intrauterine growth restriction (IUGR), placental abruption or stillbirth). Controls were women matched for age at delivery and parity.
METHODS: Clinical data were collected by obstetricians or midwives during antenatal care visits and delivery, and recorded by trained research assistants.
METHODS: Occurrence of a vasculo-placental disorder.
RESULTS: 505 women with vasculo-placental disorder (299 pre-eclampsia, 253 IUGR, 44 placental abruptions, 11 stillbirths) and 1515 matched controls were selected out of 20,075 participants. In multivariable analysis, four clinical parameters were associated with pre-eclampsia: obesity (Odd ratio (OR) = 3.11, 95%CI 2.11-4.58), French overseas origin (OR = 4.41, 95%CI 1.87-10.42), previous vasculo-placental disorder (OR = 5.14, 95%CI 2.72-9.70), aspirin during pregnancy (OR = 10.10, 95%CI 1.99-51.08). Three clinical parameters were associated with IUGR: auto-immune/inflammatory disorder (OR = 3.75, 95%CI 1.83-7.68), previous vasculo-placental disorder (OR = 3.63, 95%CI 2.06-6.41), smoking during pregnancy (OR = 2.66, 95%CI 1.91- 3.71). A previous venous thromboembolism (VTE) was associated with IUGR in univariable but not in multivariable analysis (OR = 3.72, 95%CI 0.82-17.00, p = 0.09).
CONCLUSIONS: Clinical risk factors differ between IUGR and pre-eclampsia, the later, but not the former, being associated with cardiovascular risk factors.
摘要：
目的：确定单胎妊娠中血管胎盘疾病的临床危险因素。
方法：在HEMOTHEPP法国队列中进行前瞻性病例对照研究。
方法：6月之间分娩的妇女，2015年1月,2019年在Finistère的任何产科病房。
方法：病例为患有血管胎盘疾病的女性（先兆子痫，宫内生长受限（IUGR），胎盘早剥或死胎)。对照组为分娩年龄和产次匹配的女性。
方法：产科医生或助产士在产前护理就诊和分娩期间收集临床数据，并由训练有素的研究助理记录。
方法：血管胎盘疾病的发生。
结果：505名患有血管胎盘疾病的妇女（299名先兆子痫，253IUGR,44胎盘破裂，在20,075名参与者中选择了11例死胎）和1515例匹配的对照。在多变量分析中，四个临床参数与先兆子痫相关：肥胖（奇数比（OR）=3.11，95CI2.11-4.58），法国海外血统（OR=4.41，95CI1.87-10.42），既往血管胎盘疾病（OR=5.14，95CI2.72-9.70），孕期阿司匹林(OR=10.10,95CI1.99-51.08)。三个临床参数与IUGR相关：自身免疫/炎性疾病（OR=3.75，95CI1.83-7.68），既往血管胎盘疾病（OR=3.63，95CI2.06-6.41），怀孕期间吸烟（OR=2.66，95CI1.91-3.71）。在单变量分析中，先前的静脉血栓栓塞（VTE）与IUGR相关，但在多变量分析中没有（OR=3.72，95CI0.82-17.00，p=0.09）。
结论：IUGR和先兆子痫的临床危险因素不同，后来,但不是前者，与心血管危险因素有关。
方法：在HEMOTHEPP法国队列中进行前瞻性病例对照研究。
方法：6月之间分娩的妇女，2015年1月,2019年在Finistère的任何产科病房。
方法：病例为患有血管胎盘疾病的女性（先兆子痫，宫内生长受限（IUGR），胎盘早剥或死胎)。对照组为分娩年龄和产次匹配的女性。
方法：产科医生或助产士在产前护理就诊和分娩期间收集临床数据，并由训练有素的研究助理记录。
方法：血管胎盘疾病的发生。
结果：505名患有血管胎盘疾病的妇女（299名先兆子痫，253IUGR,44胎盘破裂，在20,075名参与者中选择了11例死胎）和1515例匹配的对照。在多变量分析中，四个临床参数与先兆子痫相关：肥胖（奇数比（OR）=3.11，95CI2.11-4.58），法国海外血统（OR=4.41，95CI1.87-10.42），既往血管胎盘疾病（OR=5.14，95CI2.72-9.70），孕期阿司匹林(OR=10.10,95CI1.99-51.08)。三个临床参数与IUGR相关：自身免疫/炎性疾病（OR=3.75，95CI1.83-7.68），既往血管胎盘疾病（OR=3.63，95CI2.06-6.41），怀孕期间吸烟（OR=2.66，95CI1.91-3.71）。在单变量分析中，先前的静脉血栓栓塞（VTE）与IUGR相关，但在多变量分析中没有（OR=3.72，95CI0.82-17.00，p=0.09）。
结论：IUGR和先兆子痫的临床危险因素不同，后来,但不是前者，与心血管危险因素有关。
