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.
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。