بررسی عوامل خطر پره اکلامپسی، یک مطالعه مورد شاهدی

Abstract

this study performed in order to investigate the risk factors of preeclampsia including the demographic and contextual factors,determining the role of nutrition status and determine the effects of stress onincidence of preeclampsia. Method:In this case-control study, 100 pregnant women with preeclampsia (as case group) and 200 normal women (as controls) were studied. A questionnaire including demographic data and underlying diseases such as diabetes mellitus, history of infertility and medication for pregnancy, gestational diabetes, a maternal history of pre-eclampsia and in her first-degree relatives, stress and nutritional status of patients during pregnancy till 3 days after delivery was completed. An informed consent was obtained from each patient before filling the questionnaire. Results:Mean weight of pregnant women in the case group was 71.14 13.68 kg and 66.67 13.44 kg in controls (P = 0.007). In the case group the history of preeclampsia was positive in 12 patients (12%) and wasnegative in 88 patients (88%). In the control group, 3 patients (1.5%) had a positive history of preeclampsia and 197 patients (98.5 %) was negative in this regard (P <0.0001). in the case group the history of pre-eclampsia in the mother of pregnant person was positive in 7 patients (7%) and was negative in 93 patients (93%), the controls status was 1 (0.5%) positive and 199 (99.5 %) negative cases regarding this factor (P = 0.002). In the case group the history of pre-eclampsia in the sister of pregnant person was positive in in 13 patients (13%) and was negative in 87 patients (87%) were negative. In the control group, he history of pre-eclampsia in the sister of pregnant person was positive in 2 patients (1%) and was negative in 198 (99%) patients (P <0.0001). Mean systolic blood pressure was 154 1.5 mmHg vs. 113.13 0.86 mmHg in case and controls respectively (P = 0.03). Also mean diastolic blood pressure was 100.95 1.14 mmHg vs. 72.05 0.7 mmHg in case and controls respectively (P = 0.02). The history of infertility was positive in 23 (23%) and negative in in 77 patients (77%) in case group. Also the history of infertility was positive in 23 patients (11.5 %) and negative in 177 patients (88.5 %) in controls (P = 0.008), also there was a positive and significant correlation between theinfertility and incidence of preeclampsia with Pearson's coefficient of 0.15 and a significance level of 0.009., با هدف بررسی عواملخطرپرهاکلامپسی از جمله تعییننقشعواملدموگرافیکوزمینهای، تعییننقشتغذیهو تعییناثرفشارروحیدربروزپرهاکلامپسی انجام پذیرفت.روشکار:دراینمطالعهمورد شاهدی، 100 زن باردار مبتلا به پره اکلامپسی با ختم حاملگی به عنوان گروه مورد و 200 زن باردار نرمال به عنوان گروه کنترل بررسی شدند. پرسشنامه ای مشتمل بر اطلاعات دموگرافیک بیماران و بیماری های زمینه ای مانند دیابت ملیتوس، سابقه نازایی و مصرف دارو برای حاملگی، دیابت حاملگی، سابقه پره اکلامپسی در افراد فامیل درجه یک و خود بیمار و مقیاس تفهیمی فشار روحی و وضعیت تغذیه بیمار در طی حاملگی تا 3 روز پس از زایمان و پس از اخذ رضایت کتبی از بیماران تکمیل گردید. نتایج:در آنالیز چند متغیره، زنان نخست زا (OR: 0/7, 95% CI: 1/1 2/9)،دارای اضافه وزن (OR: 0/024, 95% CI: 1/2 7/72)، با سابقه دیابت قبل بارداری (OR: 0/97, 95% CI: 0/93 1/004)، با سابقهپرهاکلامپسی در بارداری های قبلی(OR: 0/11, 95% CI: 0/031 0/4)، با سابقهپره اکلامپسیدرمادر(OR: 0/06, 95% CI: 0/008 0/5)، با سابقهپرهاکلامپسیدرخواهر(OR: 0/06, 95% CI: 0/015 0/3)و با سابقه نازایی (OR: 2/2, 95% CI: 1/21 4/3)در معرض خطر بالای ابتلا به پره اکلامپسی قرار داشتند. اما تحصیلات مادر، شعل همسر، سن همسر، وضعیت اقتصادی خانواده، دیابت بارداری، سابقه خانوادگی دیابت، تعداد سقط قبلی، میزان فشار روحی وارده بر فرد و تغذیه ارتباطی با افزایش خطر ابتلا به پره اکلامپسی نداشت