早发型重度子痫前期相关影响因素研究
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摘要
目的：探讨影响梅州地区早发型重度子痫前期的危险因素,了解早发型重度子痫前期和晚发型重度子痫前期发病影响因素是否有差异。
方法：采用病例-对照研究设计。选择2007.12-2009.12于梅州市人民医院就诊的重度子痫前期患者为病例组,按发病时间分为早发型重度子痫前期(EOSP)和晚发型重度子痫前期(LOSP),有效病例共204例。选取同期入院待产未患相关疾病的产妇为对照组,有效病例共204例。每一位病例及对照均进行面访或者电话调查完成一份问卷,查阅相应病历资料。数据使用SPSS13.0软件进行录入及统计分析。
结果：1.人口社会学因素：早发组和对照组人口社会学因素比较：年龄、职业、文化程度、经济状况差异有统计学意义(p<0.05),经单因素Logistic回归分析显示年龄≥35岁、无固定职业、初中以下文化和人均月收入低于800元为EOSP的危险因素。
2.妊娠相关临床特征：早发组和对照组在胎儿性别、基础舒张压、孕期增重、不良分娩史、妊娠合并病毒性肝炎、妊娠期糖尿病史和人工流产史差异无统计学意义(P>0.05)；其余有意义的因素经单因素logistic回归分析及把年龄、职业、文化程度、经济收入作为混杂因素进行调整后发现双胎、两地分居、没有规律产检、“0”型血、水肿、有自然流产史及肾炎史与EOSP的发病呈正相关,而非计划内妊娠、妊娠间隔时间≥10年、基础收缩压≥130mmHg、孕前BMI≥24Kg/m2、经产妇、非初孕妇和有高血压家族史与EOSP的发生无统计学的意义。
3.精神、心理及生活习惯因素：经单因素logistic回归分析以及相关因素的调整之后发现日常劳动强度大、孕期压力大、负性生活事件、孕期情绪不良、生活不规律、孕前缺乏体育锻炼、孕期缺乏体育锻炼为EOSP的危险因素；而每天不能保证8小时以上睡眠与EOSP发病无关联。
4.饮食因素：食用新鲜蔬菜、水果、新鲜肉类、豆制品、菌藻类、蛋类、到餐馆就餐情况、喜食鸡精或味精情况比较,差异无显著性(P>0.05)；其余有意义的因素经单因素logistic回归分析及相关因素调整后显示少喝牛奶、很少食新鲜鱼虾、经常吃盐煽食品、腊制品、甜品、腌菜和油腻食品、食用动物油、喜食咸、未添加钙剂、叶酸和维生素为EOSP发病的危险因素。
5.多因素非条件Logistic回归分析,得出EOSP的危险因素及其OR值为：未定期产检(OR=14.828)、年龄≥35岁(OR=7.859)、孕前BMI≥24(OR=24.046)、非计划内妊娠(OR=35.569)、自然流产史(OR=63.015)、孕期压力大(OR=4.401)、孕期情绪不良(OR=7.070)、孕期负性事件(OR=39.504)、孕期缺乏体育锻炼(OR=7.356)、孕前缺乏体育锻炼(OR=4.771)、少饮用牛奶(OR=5.140)、少食新鲜鱼虾(OR=9.856)、常食甜品(OR=10.560)常食腌菜(OR=13.071)、未添加钙剂(OR=5.834)、常食用高脂食品(OR=6.175)。
6.早发组和晚发组发病相关影响因素比较：未定期产检、肾炎史、自然流产史、孕期饮用牛奶、添加钙剂和维生素的情况有显著性的差异(P<0.05)。
7.早发组分别和对照组、晚发组进行实验室和妊娠结局的比较：URIC、TG、CH水平显著升高：HDL水平下降：早产、低出生体重儿、死产及新生儿窒息、分娩期并发症的的发生率显著增加。
结论：
1.未定期产检、年龄≥35岁、孕前BMI≥24、自然流产史是EOSP发病的危险因素；而孕次、产次、人工流产次数与EOSP的发病无显著相关。
2.孕前及孕期坚持适当体育锻炼有利于防止EOSP的发生。
3.在饮食方面：孕期多喝牛奶、多吃新鲜鱼虾、补充钙剂可降低EOSP的风险；而经常食用高糖、高盐及高脂食品是EOSP发病的危险因素。
4.基础收缩压≥130mmHg、基础舒张压≥80mmHg、高血压家族史并未发现与EOSP的发病显著相关。
5.精神、心理因素方面：非计划内妊娠、孕期压力过大、孕期情绪不良以及孕期负性事件与EOSP的发病显著相关；但是孕期睡眠时间是否达到8小时与EOSP的发病无显著相关性。
6.早发组和晚发组比较：未定期产检、肾炎史、自然流产史、孕期饮用牛奶、添加钙剂和维生素的情况有显著性的差异。
Object:To explore the risk factors of early onset severe preeclampsia and find the difference of the risk factors between early onset severe preeclampsia and late onset severe preeclampsia in Meizhou area.
Methods:We conducted a case control study involving 204 native pregnant women with severe preeclampsia as case group and 204 cases who had no related diseases as control group from December 2007 to December 2009 in the first hospital of Meizhou City. According to the onset time, the severe preeclampsia patients were divided into early onset severe preeclampsia (<34w) and late onset severe preeclampsia (>34w). Each case of case group and control group were conducted to complete a questionnaire by interview or phone and the medical record was used. SPSS13.0 software was used for data entry and statistical analysis.
Result:1.We observed the differences between early-onset group and control group in maternal age, maternal education, occupation and economic status. Results from univariate analysis showed that maternal age≥35 years old, junior high school education below, no stable job and Per capita monthly income<800 were risk factors of EOSP.
2. Compared the early-onset group with the control group in clinical features of pregnance. fetu's gender,the basis of diastolic blood pressure, weight gain during pregnancy, history of adverse birth, viral hepatitis during pregnancy, history of gestational diabetes and history of induced abortion had no statistically significant difference (p>0.05).While the factors statistically significant differences were analysised by univariate analysis and confounding factors such as maternal age, maternal education,occupation,economic status were adjusted.we found twins,women not living with the infant's father, irregular prenatal care, irregular prenatal care,blood group "O", edema, History of nephritis were positive associated with the incidence of EOSP.While there were no statistical signification was found in unplanned pregnancy,the pregnancy interval≥10years,the basis of systolic blood pressure≥130mmHg, pre-pregnancy BMI≥24Kg/m2,multipara,times of gravidity≥2,family history of hypertension.
3. Factors in psychological and lifestyle:Results from univariate analysis and confounding factors adjusted showed that daily labor strength,stressful during pregnancy,negative events during pregnancy,negative emotions during pregnancy,irregular life,lack of exercise during pregnancy and pre-pregnancy were risk factors of EOSP.
4. Factors in the diet:There was no statistically difference in fresh vegetables and fruits,meat,bean products,algae,eggs,dining in the restaurant and MSG. While the factors statistically significant differences were analysised by univariate analysis and confounding factors such as maternal age, maternal education,occupation,economic status were adjusted,we found less intake of milk and fresh fish and shrimp,greater intake of desserts,salted vegetables and high-fat foods,edible animal oil,addicted to salt,no addition of calcium,folic acid and vitamin during pregnance were risk factors of EOSP.
5. Multivariate logistic regression analysis with factors selected by univariate analysis significant showed that irregular prenatal care(OR=14.828),maternal age≥35(OR=7.859),body mass index≥24 (OR=24.046),unplanned pregnancy (OR=35.569),history of spontaneous abortion (OR=63.015),stressful during pregnancy(OR=4.401),negative emotions during pregnancy(OR=7.070),negative emotions during pregnancy (OR=39.504,),lack of exercise during pregnancy(OR=7.356) and before pregnancy (OR=4.771),less intake of milk(OR=5.140), fish(OR=9.856) and calicium (OR=5.834),greater intake of desserts(OR=10.560),salted vegetables (OR=13.071)and high fatty foods (OR=6.175) were the main risk factors of EOSP。
6. Compared the early-onset group with late-onset group in related factors showed that there were something different significant in history of nephritis,history of spontaneous abortion,irregular life,emotional state during pregnancy,drinking milk,added calcium and Vitamin.
7.Compared the early-onset group with late-onset group and control group, There were significant decrease in HDL and increase in URIC,TG and CH levels as well as the high incidence of premature,low birth weight,stillbirth and childbirth complications。
Conclusion:1. Irregular prenatal care, maternal age≥35, body mass index≥24,history of spontaneous abortion are risk factors for EOSP; Howere, Times of pregnancy, parity,history of induced abortion are not associated with higher risk of having EOSP.
2. Regular physical activity during pregnancy and pre-pregnancy reduces the risk of EOSP.
3. Factors in the diet:greater intake of milk,fresh fish and supplement calcium reduces the risk of having EOSP;However, greater intake of high glucose,high-salt and high-fat foods are associated with higher risk of having EOSP.
4.The basis of systolic blood pressure≥130mmHg,the basis of diastolic blood pressure≥80mmHg and family history of hypertension are not associated with higher risk of having EOSP.
5.Factors in psychological:irregular prenatal care,stressful during pregnancy,negative emotions during pregnancy and negative emotions during pregnancy are risk factors of having EOSP, While less than 8 hours of sleep per day is no statistical signification.
6.Compared the early onset group with the late onset group, We find statistically significant differences in irregular prenatal care,history of nephritis,history of spontaneous abortion,irregular life,emotional state during pregnancy,drinking milk, added calcium and vitamin.
方法：采用病例-对照研究设计。选择2007.12-2009.12于梅州市人民医院就诊的重度子痫前期患者为病例组,按发病时间分为早发型重度子痫前期(EOSP)和晚发型重度子痫前期(LOSP),有效病例共204例。选取同期入院待产未患相关疾病的产妇为对照组,有效病例共204例。每一位病例及对照均进行面访或者电话调查完成一份问卷,查阅相应病历资料。数据使用SPSS13.0软件进行录入及统计分析。
结果：1.人口社会学因素：早发组和对照组人口社会学因素比较：年龄、职业、文化程度、经济状况差异有统计学意义(p<0.05),经单因素Logistic回归分析显示年龄≥35岁、无固定职业、初中以下文化和人均月收入低于800元为EOSP的危险因素。
2.妊娠相关临床特征：早发组和对照组在胎儿性别、基础舒张压、孕期增重、不良分娩史、妊娠合并病毒性肝炎、妊娠期糖尿病史和人工流产史差异无统计学意义(P>0.05)；其余有意义的因素经单因素logistic回归分析及把年龄、职业、文化程度、经济收入作为混杂因素进行调整后发现双胎、两地分居、没有规律产检、“0”型血、水肿、有自然流产史及肾炎史与EOSP的发病呈正相关,而非计划内妊娠、妊娠间隔时间≥10年、基础收缩压≥130mmHg、孕前BMI≥24Kg/m2、经产妇、非初孕妇和有高血压家族史与EOSP的发生无统计学的意义。
3.精神、心理及生活习惯因素：经单因素logistic回归分析以及相关因素的调整之后发现日常劳动强度大、孕期压力大、负性生活事件、孕期情绪不良、生活不规律、孕前缺乏体育锻炼、孕期缺乏体育锻炼为EOSP的危险因素；而每天不能保证8小时以上睡眠与EOSP发病无关联。
4.饮食因素：食用新鲜蔬菜、水果、新鲜肉类、豆制品、菌藻类、蛋类、到餐馆就餐情况、喜食鸡精或味精情况比较,差异无显著性(P>0.05)；其余有意义的因素经单因素logistic回归分析及相关因素调整后显示少喝牛奶、很少食新鲜鱼虾、经常吃盐煽食品、腊制品、甜品、腌菜和油腻食品、食用动物油、喜食咸、未添加钙剂、叶酸和维生素为EOSP发病的危险因素。
5.多因素非条件Logistic回归分析,得出EOSP的危险因素及其OR值为：未定期产检(OR=14.828)、年龄≥35岁(OR=7.859)、孕前BMI≥24(OR=24.046)、非计划内妊娠(OR=35.569)、自然流产史(OR=63.015)、孕期压力大(OR=4.401)、孕期情绪不良(OR=7.070)、孕期负性事件(OR=39.504)、孕期缺乏体育锻炼(OR=7.356)、孕前缺乏体育锻炼(OR=4.771)、少饮用牛奶(OR=5.140)、少食新鲜鱼虾(OR=9.856)、常食甜品(OR=10.560)常食腌菜(OR=13.071)、未添加钙剂(OR=5.834)、常食用高脂食品(OR=6.175)。
6.早发组和晚发组发病相关影响因素比较：未定期产检、肾炎史、自然流产史、孕期饮用牛奶、添加钙剂和维生素的情况有显著性的差异(P<0.05)。
7.早发组分别和对照组、晚发组进行实验室和妊娠结局的比较：URIC、TG、CH水平显著升高：HDL水平下降：早产、低出生体重儿、死产及新生儿窒息、分娩期并发症的的发生率显著增加。
结论：
1.未定期产检、年龄≥35岁、孕前BMI≥24、自然流产史是EOSP发病的危险因素；而孕次、产次、人工流产次数与EOSP的发病无显著相关。
2.孕前及孕期坚持适当体育锻炼有利于防止EOSP的发生。
3.在饮食方面：孕期多喝牛奶、多吃新鲜鱼虾、补充钙剂可降低EOSP的风险；而经常食用高糖、高盐及高脂食品是EOSP发病的危险因素。
4.基础收缩压≥130mmHg、基础舒张压≥80mmHg、高血压家族史并未发现与EOSP的发病显著相关。
5.精神、心理因素方面：非计划内妊娠、孕期压力过大、孕期情绪不良以及孕期负性事件与EOSP的发病显著相关；但是孕期睡眠时间是否达到8小时与EOSP的发病无显著相关性。
6.早发组和晚发组比较：未定期产检、肾炎史、自然流产史、孕期饮用牛奶、添加钙剂和维生素的情况有显著性的差异。
Object:To explore the risk factors of early onset severe preeclampsia and find the difference of the risk factors between early onset severe preeclampsia and late onset severe preeclampsia in Meizhou area.
Methods:We conducted a case control study involving 204 native pregnant women with severe preeclampsia as case group and 204 cases who had no related diseases as control group from December 2007 to December 2009 in the first hospital of Meizhou City. According to the onset time, the severe preeclampsia patients were divided into early onset severe preeclampsia (<34w) and late onset severe preeclampsia (>34w). Each case of case group and control group were conducted to complete a questionnaire by interview or phone and the medical record was used. SPSS13.0 software was used for data entry and statistical analysis.
Result:1.We observed the differences between early-onset group and control group in maternal age, maternal education, occupation and economic status. Results from univariate analysis showed that maternal age≥35 years old, junior high school education below, no stable job and Per capita monthly income<800 were risk factors of EOSP.
2. Compared the early-onset group with the control group in clinical features of pregnance. fetu's gender,the basis of diastolic blood pressure, weight gain during pregnancy, history of adverse birth, viral hepatitis during pregnancy, history of gestational diabetes and history of induced abortion had no statistically significant difference (p>0.05).While the factors statistically significant differences were analysised by univariate analysis and confounding factors such as maternal age, maternal education,occupation,economic status were adjusted.we found twins,women not living with the infant's father, irregular prenatal care, irregular prenatal care,blood group "O", edema, History of nephritis were positive associated with the incidence of EOSP.While there were no statistical signification was found in unplanned pregnancy,the pregnancy interval≥10years,the basis of systolic blood pressure≥130mmHg, pre-pregnancy BMI≥24Kg/m2,multipara,times of gravidity≥2,family history of hypertension.
3. Factors in psychological and lifestyle:Results from univariate analysis and confounding factors adjusted showed that daily labor strength,stressful during pregnancy,negative events during pregnancy,negative emotions during pregnancy,irregular life,lack of exercise during pregnancy and pre-pregnancy were risk factors of EOSP.
4. Factors in the diet:There was no statistically difference in fresh vegetables and fruits,meat,bean products,algae,eggs,dining in the restaurant and MSG. While the factors statistically significant differences were analysised by univariate analysis and confounding factors such as maternal age, maternal education,occupation,economic status were adjusted,we found less intake of milk and fresh fish and shrimp,greater intake of desserts,salted vegetables and high-fat foods,edible animal oil,addicted to salt,no addition of calcium,folic acid and vitamin during pregnance were risk factors of EOSP.
5. Multivariate logistic regression analysis with factors selected by univariate analysis significant showed that irregular prenatal care(OR=14.828),maternal age≥35(OR=7.859),body mass index≥24 (OR=24.046),unplanned pregnancy (OR=35.569),history of spontaneous abortion (OR=63.015),stressful during pregnancy(OR=4.401),negative emotions during pregnancy(OR=7.070),negative emotions during pregnancy (OR=39.504,),lack of exercise during pregnancy(OR=7.356) and before pregnancy (OR=4.771),less intake of milk(OR=5.140), fish(OR=9.856) and calicium (OR=5.834),greater intake of desserts(OR=10.560),salted vegetables (OR=13.071)and high fatty foods (OR=6.175) were the main risk factors of EOSP。
6. Compared the early-onset group with late-onset group in related factors showed that there were something different significant in history of nephritis,history of spontaneous abortion,irregular life,emotional state during pregnancy,drinking milk,added calcium and Vitamin.
7.Compared the early-onset group with late-onset group and control group, There were significant decrease in HDL and increase in URIC,TG and CH levels as well as the high incidence of premature,low birth weight,stillbirth and childbirth complications。
Conclusion:1. Irregular prenatal care, maternal age≥35, body mass index≥24,history of spontaneous abortion are risk factors for EOSP; Howere, Times of pregnancy, parity,history of induced abortion are not associated with higher risk of having EOSP.
2. Regular physical activity during pregnancy and pre-pregnancy reduces the risk of EOSP.
3. Factors in the diet:greater intake of milk,fresh fish and supplement calcium reduces the risk of having EOSP;However, greater intake of high glucose,high-salt and high-fat foods are associated with higher risk of having EOSP.
4.The basis of systolic blood pressure≥130mmHg,the basis of diastolic blood pressure≥80mmHg and family history of hypertension are not associated with higher risk of having EOSP.
5.Factors in psychological:irregular prenatal care,stressful during pregnancy,negative emotions during pregnancy and negative emotions during pregnancy are risk factors of having EOSP, While less than 8 hours of sleep per day is no statistical signification.
6.Compared the early onset group with the late onset group, We find statistically significant differences in irregular prenatal care,history of nephritis,history of spontaneous abortion,irregular life,emotional state during pregnancy,drinking milk, added calcium and vitamin.
引文
[1]刘敬涛,熊庆,梁家智,等.四川省2003年孕产妇死亡潜在损失分析[J]·中华妇产科学杂志,2005,40(4)：246-248.
[2]谭晶,秦敏,朱丽萍.上海市2000-2007年孕产妇死亡情况分析[J].中国妇幼保健,2008,23(28)：3954-3957.
[3]Branch DW,AndresR,DigreKB,et al.Theassociation of antiphospholipid atibodies with severe preeclampsia[J].Osbte Gynecol,1989,73:541-545.
[4]Dadelszen P V, Magee LA, Roberts JM.Subclassification of preeclampsia[J].Hypertens Pregnancy,2003,22(2):143-148.
[5]杨孜,李蓉,石凌懿等.早发型重度子痫前期的临床界定及保守治疗探讨[J].中华妇产科杂志,2005,40：302-305.
[6]ShenhavS,GemerO,Sassoc n E,et al.Mid-trimestertirple testlevelsin early and late onset Severe preelampsia[J].PrenatalDiagnosis,2002,22:579-582.
[7]贺晶,上官雪军,温泓,等.早发型重度妊高征的临床研究[J].中国妇幼保健,2004,19(11)：61-63.
[8]李笑天,病理妊娠[M]//丰有吉,沈铿.妇产科学,北京：人民卫生出版社,2005：74-82.
[9]段涛,妊娠期高血压疾病的热点问题讨论[J].现代妇产科进展,2004,(6)：401-405.
[10]Haddad B,Deis S,Got-inetF,et al.Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation[J].Am J Obstet Gynecol,2004,190(6):1590-1597.
[11]杨孜,早发型重度子痫前期及严重并发症之防范是产科的又一新挑战[J].中华医学杂志,2008,88(11)：727-729.
[12]Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia:current concepts[J]. Am J Obstet Gynecol,1998,179:1359-1375.
[13]苟文丽,妊娠期高血压疾病[M]//乐杰.妇产科学(第七版),北京：人民卫生出版社,2008：92-99.
[14]Austgulen R, Isaksen CV, Chedwick L,et al.Craven C. Preeclampsia:associated with increased syncytial apoptosis when the infant is small-for-gestational-age[J]. J Reprod Immunol.2004,61:39-45.
[15]Crocker IP, Cooper S, Ong SC, et al. Differences in apoptotic susceptibility of cytotrophoblasts and syncytiotrophoblasts in normal pregnancy to those complicated with preeclampsia and intrauterine growth restriction[J]. Am J Pathol,2003,162:637-643.
[16]Sargent IL, Germain SJ, Sacks GP, Kumar S, Redman CW. Trophoblast deportation and the maternal inflammatory response in pre-eclampsia[J]. J Reprod Immunol,2003; 59: 153-60
[17]Johansen M, Redman CW, Wilkins T, et al.Trophoblast deportation in human pregnancy--its relevance for pre-eclampsia[J]. Placenta,1999;20:531-539.
[18]杨孜.早发型重度先兆子痫一产科医生面临的挑战[J].中国妇产科临床杂志,2003,4(2)：83-84.
[19]Goswami D, Tannetta DS, et al.Excess syncytiotrophoblast microparticle shedding is a feature of early-onset pre-eclampsia, but not normotensive intrauterine growth restriction[J]. Placenta.2006;27(1):56-61.
[20]Sitras V,Paulssen RH,et al.Differential Placental Gene Expression in Severe Preeclampsia [J].placenta.2009.30(5):424-433.
[21]李志杰,张文真,胡建秀,胎盘及外周血中STBM与早发型重度子痫前期病因的研究[J].实用妇产科杂志,2008,24(11)：677-681.
[22]Shenhav S,Gemer O,Soon E,et al.Mid-trimester tirplestlevels in early and lati-onset severe preeclampsia[J].prenat Diagn,2002,22(7):579-582.
[23]Egbor M, Ansari T, Morris N, et al.Morphometric placental villous and vascular abnormalities in early-and late-onset pre-eclampsia with and with-out fetal growth restriction[J].Br J Obstet Gynaecol,2006,113 (5):580-589.
[24]Rasm,IrgensLM.Fetal growth and body proportion in preeclampsia[J]ObstetGynecol,2003, 101(3):575-583.
[25]杨孜,王伽略,黄萍,等.重度子痫前期终末器官受累不平行性及其围产结局探讨[J].中华围产医学杂志,2006,9(9)：10-14.
[26]凌婉文,林建华,林其德等.妊娠期高血压疾病凝血相关指标的变化[J].上海交通大学学报·医学版,2008,28(1)：77-79.
[27]张新艳,姚元庆.早发型重度子痫前期相关问题[J].中国实用妇科与产科杂志,2009,25(4)：243-245.
[28]乔福元,妊娠期高血压疾病[M]//谢幸,孔北华.妇产科学,北京：人民卫生出版社,2007：104-112.
[29]Bianco A, Stone J, Lynch L, et al. Pregnancy outcome at age 40 and older[J].Obstet Gynecol,1996,87:917-922.
[30]Saftlas AF, Olson DR, Franks Al,et al. Epidemiology of preeclampsia and eclampsia in the United states,1979-1986[J]. Am J Obstet Gynecol,1990,163:460-465.
[31]彭波,袁秀琴.妊娠高血压综合征危险因素的Meta分析[J].南华大学学报·医学版,2009,37(2)：144-149.
[32]冯启明,李慕军,黄星,等.妊娠高血压综合征危险因素的Logistic回归分析[J].广西医科大学学报,2004,21(3)：325-327.
[33]雷玉秀,李凤莲,王玉梅.妊娠高血压综合征13年发病规律及相关因素病例对照分析[J].中国妇幼保健,2007,22(28)：3943-3945.
[34]Kurki T, Hiilesmaa V, Raitasalo R, et al. Depression and anxiety in early pregnancy and risk for preeclampsia[J]. Obstet Gynecol,2000,95(4):487-490.
[35]卫关华.妊高征的社会心理因素及预防措施[J].中华中西医学杂志,2004,2(10)：16-18.
[36]Qiu C, Williams MA, Calderon-Margalit R, etal.Preeclampsia Risk in Relation to Maternal Mood and Anxiety Disorders Diagnosed Before or During Early Pregnancy [J].Am J Hypertension,2009,22(4):397-402.
[37]尹春艳,张翠琼等,婚姻质量与妊娠期高血压疾病的相关性研究[J],南方医科大学学报2007,27(11)：1674-1676.
[38]TK Sorensen, MA Williams, I Lee,et al. Recreational Physical Activity During Pregnancy and Risk of Preeclampsia[J].Hypertension,2003,41:1273-1280.
[39]Magnus P, Trogstad L, et al.Recreational Physical Activity and the Risk of Preeclampsia: A Prospective Cohort of Norwegian Women[J].American Journal of Epidemiology,2008 168(8):952-957.
[40]黄萍,杨孜等,重度子痫前期191例严重并发症的监测[J].中国实用妇科与产科杂志,2006,22(11)：828-831.
[41]杨湘军,李娜等,重度子痫前期患者的分娩时机及方式探讨[J].中国妇幼保健,2008,23(1)：35-36.
[42]任景慧,徐宏里,林琳华,等.630例孕妇孕前孕早期保健状况分析[J].中国实用妇科与产 科杂志,2000,16(10)：635-636.
[43]张泽峰,蓝绍颖,储海涛等.我国甲类农村地区孕产妇产前检查次数方案效果评价[J].南通医学院学报,1998,18(3)：305-306.
[44]Lee CJ, Hsieh TT, Chiu TH, et al. Risk factors for pre-eclampsia in an Asian population[J]. Int J Gynecol Obstet,2000,70:327-333.
[45]Agustin Conde-Agudelo, JosC MB. Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women[J]. BJOG,2000,107(1):75-83.
[46]Skjaerven R, Wilcox AJ, Lie RT. The interval between pregnancies and the risk of preeclampsia[J]. N Engl J Med,2002;346(1):33-38.
[47]Olga Bassol,2, Clarice R. Weinberg3,et al.Subfecundity as a Correlate of Preeclampsia:A Study within the Danish National Birth Cohort[J], Am J Epidemiol,2003; 157:195-202.
[48]L Trogstad, P Magnus, A Moffett,etal.The effect of recurrent miscarriage and infertility on the risk of pre-eclampsia[J].BJOG,2009,116(1):108-13.
[49]Makkonen N, Heinonen S, Kirkinen P. Obstetric prognosis in second pregnancy after preeclampsia in first pregnancy [J]. Hypertens Pregnancy,2000,19:173-181.
[50]Dukler D, Porath A, Bashiri A, et al. Remote prognosis of primiparous women with preeclampsia[J]. Eur J Obstet Gynecol Reprod Biol,2001;96:69-74.
[51]Chesley LC, Annitto JE, Cosgrove RA. The remote prognosis of eclamptic women. Sixth periodic report[J].Am JObstetGynecol,2000,182(1Pt1):247-248.
[52]Lykke JA, Langhoff-Roos Jens, Sibai BM,et al. Hypertensive disorders in pregnancy, recurrence in a second pregnancy, and subsequent cardiovascular events [J]. Am J Obstet Gynecol,2008,199(6):S6.
[53]Sonia Hernandez-Diaz, Sengwee Toh, Sven Cnattingius.Risk of pre-eclampsia in first and subsequent pregnancies:prospective cohort study[J].BMJ,2009,338:b2255.
[54]Salonen RH,Lichtenstein P.Genetec effects on the liability of developing preeclampsia and . gestional hypertension[J]. Am J Med Genet,2000,91(4):256-260.
[55]Skj(?)rven R,Vatten LJ,Wilcox AJ,et al.Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort[J]. BMJ, 2005,331:877.
[56]Sibai BM, Lindheimer M, Hauth J, et al. Risk factors for preeclampsia, abruptio placentae, and adverse. neonatal outcomes among women with chronic hypertension[J]. New Engl J Med (1998) 339:667-671.
[57]Caritis S, Sibai B, Hauth J, et al. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units[J]. New Engl J Med,1998,338:701-705.
[58]Catov JM, Ness RB, Kip KE, et al. Risk of early or severe pre-eclampsia related to pre-existing conditions [J]. Int J Epidemiology,2007,36(2):412-419.
[59]于红,魏玮,沈杨等.子痫前期高危因素的Logistic回归分析[J].实用妇产科杂志2010,26(4)：273-275.
[60]Rigo J, BozeT, DerzsyZ, et al.Family history of early-onset cardi-ovascular disorders is associated with a higher risk of severe pre-eclampsia[J]. Eur J ObstetGynecolReprod Bio,l 2006,128(1):148-151.
[61]Chunfang Q, Michelle A. et al.Family History of Hypertension and Type 2 Diabetes in Relation to Preeclampsia risk[J].Hypertension,2003,41:408-413.
[62]LeungTY, LeungTN, Sahota DS, et al,Trends inmaternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinesewomen [J].BJOG,2008,115(12): 1529-1537.
[63]Frederick IO, RudraCB, MillerRS. Adultweight change, weight cycling, and prepregnancy obesity in relation to risk ofpreeclamp-sia[J]. Epidemiology,2006,17(4):428-434.
[64]Sebire NJ, Harris J, Regan L, et al. Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London[J].Br J Obstet Gynaecol, 2001,108:61-66.
[65]Lykke JA, Langhoff-Roos Jens, Sibai BM,et al. Hypertensive pregnancy disorders and subsequent cardiovascularmorbidity and type 2 diabetesmellitus in the mother[J]. Hypertension,2009,53(6):944-951.
[66]Ray J, Diamond P, Singh G, et al. Brief overview of maternal triglycerides as a risk factor for pre-eclampsia[J]. BJOG 2006; 113:379-386.
[67]Themn GB,Thompson ML The usefulness of a weight gain spurt to identify women who will develop preeclampsia[J].Eur J Obstet Gynecol Reprod Biol,1998,78:47-51.
[68]吏峻梅,杨孜等.重度子痫前期患者临床发病前预警信息分析[J].中华妇产科杂志,44(5)：337-340.
[69]朱玉莲,田红菊等.妊娠高血压综合征相关危险因素的研究[J].医学临床研究,2005,22(12)：1747-1748.
[70]Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking:systematic review of controlled studies[J]. BMJ,2005;330:549-50.
[71]雷马香,刘筱娴.妊娠高血压疾病危险因素的病例对照研究[J].中国社会医学杂志2009,26(3)：177-179.
[72]Zhou B, Zhang X, Zhu A, et al.The relationship of dietary animal protein and electrolytes to blood pressure:a study on three Chinese populations[J]. Int J Epidemiol. 1994,23(4):716-22.
[73]赵文华,王军波等.膳食及营养因素对农村居民高血压患病影响的多因素分析[J].营养学报,2002,24(3)：274-277.
[74]刘爱玲.甘肃省定西市贫困农村居民膳食与继发性高血压病相关调查分析[J].甘肃中医学院学报,2010,27(2)：79-80.
[75]Brantsaeter AL, Haugen M, Samuelsen SO, et al.A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women[J].J Nutr.2009,139(6):1162-8.
[76]Longo-Mbenza B, Tshimanga KB, Buassa-bu-Tsumbu B, et al.Diets rich in vegetables and physical activity are associated with a decreased risk of pregnancy induced hypertension among rural women from Kimpese, DR Congo [J].Niger J Med, 2008,17(3):265-9.
[77]Garratt FN.Pre-eclampsia:a challenge to public health teams worldwide to ensure that maternal diets contain adequate levels of folic acid, n3 polyunsaturated fatty acids and vitamin D at conception[J].Public Health,2009,123(1):95-6.
[78]丁新,黄醒华.妊娠高血压综合征患者的营养代谢状况[J].当代医学(学术版)2008,1：6-9.
[79]Holmes VA, McCance DR. Could antioxidant supplementation prevent pre-eclampsia[J]. Proc Nutr Soc.2005;64(4):491-501
[80]Lindheimer MD, Sibai BM.Antioxidant supplementation in. pre-eclampsia[J].The Lancet, 2006,367(9517):1119-1120.
[81]Beazley D, Ahokas R, Sibai BM,et al.Vitamin C and E supplementation in women at high risk for preeclampsia:a double-blind, placebo-controlled trial[J].Am J Obstet Gynecol, 2005,192:520-521.
[82]Poston L, Briley AL, Seed PT, et al. Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial):randomised placebo-controlled trial[J]. Lancet; 2006;367: 1145-1154.
[83]Rumbold AR, Crowther CA, Haslam RR, et al. Vitamins C and E and the risks of preeclampsia and perinatal complication[J]. s. N Engl J Med,2006,354:1796-1806.
[84]Lisa M,Bodnar, Gong Tang, et al,Periconceptional Multivitamin Use Reduces the Risk of Preeclampsia[J]. American Journal of Epidemiology,2006,164(5):470-477.
[85]Janet M,Ellen A,et al.Association of periconceptional Mutivitamin Use With Reduced Risk of preeclampsia Among Normal-Weight Weight Women in the Danish National Birth Cohort[J].Am J Epidemiol,2009,169:1304-1311.
[86]Punthumapol C,et al.Serum calcium, magnesium and uric acid in preeclampsia and normal pregnan[J].J Med Assoc Thai.2008,91(7):968-73.
[87]Apostol A, Apostol R, et al.Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate[J].Fertil Steril,201094(1):276-282.
[88]Hofmeyr GJ, et al.Dietary calcium supplementation for prevention of pre-eclampsia and related problems:a systematic review and commentary[J].BJOG,2007,114(8):933-43.
[89]高树生,李黎,潘兴华.妊娠高血压综合征血浆叶酸同型半胱氨酸和内皮素浓度变化[J].中国实用妇科与产科杂志,2002,18(2)：86-88.
[90]Georgios M, Alexis P, Areti H,et al. Homocysteine, folic acid and B12 serum levels in pregnancy complicated with preeclampsia[J].Arch Gynecol Obstet,2007,275:121-124.
[91]Leeda M, Riyazi N, de Vries J, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a, history of preeclampsia or fetal growth restriction[J]. Am J Obstet Gynecol,1998;179:135-139.
[92]Woo KS, Chook P, Lilin YI, et al. Folic acid improves arterial endothelial function in adults with hyperhomocysteinemia[J]. J Am Coll Cardiol,1999;34(7):2002-2006.
[93]Wen SW, Chen X-K, Rodger M, et al. Folic acid supplementation in early second trimester and the risk of preeclampsia[J]. Am J Obstet Gynecol,2008,198:45.e1-45.e7.
[94]李智慧.口服小剂量叶酸预防妊娠高血压疾病的临床研究[J].吉林医学,200930(15)：1678-1679.
[95]Oken E, Ning Y, Rifas-Shiman SL, et al.Diet During Pregnancy and Risk of Preeclampsia or Gestational Hypertension[J].Ann Epidemiol,2007,17(9):663-668.
[96]陈春明.防治肥胖刻不容缓[J].中华预防医学杂志,2001,35(5)：291-292·
[97]张文彤主编.世界优秀统计工具SPSS 11.0统计分析教程(高级篇)[M].北京希望电子出版社,2004,82-83.
[98]万淑梅,余艳红,黄莺莺.妊娠期高血压疾病严重并发症的发生规律及其对母儿的影响[J].中华妇产科杂志,2007,42(8)：510-514.
[99]熊波,晏元辉.妊娠高血压疾病患者生活质量及社会支持调查[J].中国现代医生,2010,48(19)：58-59.
[100]罗聪,刘莉雁.高血压病与ABO血型关系流行病学调查研究[J].吉林大学学报(医学版),1989(2)：143-144.
[101]陈少华,陈爱国,冯福英.ABO血型与高血压、糖尿病及哮喘的相关性探讨[J].中国优生与遗传杂志,2003,11(6)：139-140.
[102]代炳梅,隗伏冰李巧仪.早发型重度子痫前期的临床特点分析[J].中国现代医生,2008,46(18)：26-29.
[103]Knivat M.Eclampsia in the United Kingdom 2005[J].BJOG,2007,114(9):1072-1078.
[104]E B Magnussen, L J Vatten.Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia:population based cohort study[J].BMJ 2007,335(7627):945-946.
[105]Sibai BM, DekkerG, KupfermincM. Pre-eclampsia[J]. Lancet,2005,365(9461):785-799.
[106]杨孜,王伽略.子痫前期临床防范和处理关键点[J].实用妇产科杂志,2010,26(1)：4-7.
[107]Lill Trogstad,Per Magnus, et al, Previous abortions and risk of pre-eclampsia[J]. International Journal of Epidemiology,2008,37(6):1333-1340.
[108]倪帼华,丁惠群.妊娠高血压综合征的影响因素研究[J].中国妇幼保健,2006,21(5)：621-622.
[109]Takiuti NH, Kahhale S, Zugaib M, et al.Stress in pregnancy:a new Wistar rat model forhuman preeclampsia[J]. Am J Obstet Gynecol.2002;186(3):544-550.
[110]洪照光.生活方式与高血压病[J].临床内科杂志,1999,16(1)：1-3.
[111]Weissgerber TL,Wolfe LA,Davies GA. the role of regular physica-lactiv ity in preeclampsia prevention [J]. Med Sci Sports Exerc,2004,36 (12):2024-2031.
[112]Tanya K,Sorensen, et al.Recreational Physical Activity During Pregnancy and Risk of Preeclampsia[J]. Hypertension,2003,41:1273-1280.
[113]孙敏娜,马瑞琼,杨孜.高脂饮食对apoE-/-子痫前期样改变孕鼠血脂和妊娠结局影响研究[J].中华医学杂志,2010,90(19)：1342-1347.
[114]刘小清,饶栩栩,李义和等.利用食物频数法对广东三个人群进行膳食分析[J].岭南心血管病杂志,1997,3(3)：1-3.
[115]Sanrelainen H,Laitinen T,Raitakari OT, et al.Pregnancy-related hyperlipidemia and endothelial function in healthy women[J].Circ J.2006,70(6)-768-772.
[116]王伽略,杨孜等,子痫前期患者血脂代谢调节的探讨[J].现代妇产科进展,2006,15(6)：438-441.
[117]Lam C, Lim KH, Kang DH,et al. Uric acid and preeclampsia[J]Semin Nephrol.2005, 25(1):56-60.
[118]James M,Janet M,Preeclampsia More Than 1 Disease Or Is It? [J]. Hypertension,2008, 51:989-990.
[2]谭晶,秦敏,朱丽萍.上海市2000-2007年孕产妇死亡情况分析[J].中国妇幼保健,2008,23(28)：3954-3957.
[3]Branch DW,AndresR,DigreKB,et al.Theassociation of antiphospholipid atibodies with severe preeclampsia[J].Osbte Gynecol,1989,73:541-545.
[4]Dadelszen P V, Magee LA, Roberts JM.Subclassification of preeclampsia[J].Hypertens Pregnancy,2003,22(2):143-148.
[5]杨孜,李蓉,石凌懿等.早发型重度子痫前期的临床界定及保守治疗探讨[J].中华妇产科杂志,2005,40：302-305.
[6]ShenhavS,GemerO,Sassoc n E,et al.Mid-trimestertirple testlevelsin early and late onset Severe preelampsia[J].PrenatalDiagnosis,2002,22:579-582.
[7]贺晶,上官雪军,温泓,等.早发型重度妊高征的临床研究[J].中国妇幼保健,2004,19(11)：61-63.
[8]李笑天,病理妊娠[M]//丰有吉,沈铿.妇产科学,北京：人民卫生出版社,2005：74-82.
[9]段涛,妊娠期高血压疾病的热点问题讨论[J].现代妇产科进展,2004,(6)：401-405.
[10]Haddad B,Deis S,Got-inetF,et al.Maternal and perinatal outcomes during expectant management of 239 severe preeclamptic women between 24 and 33 weeks' gestation[J].Am J Obstet Gynecol,2004,190(6):1590-1597.
[11]杨孜,早发型重度子痫前期及严重并发症之防范是产科的又一新挑战[J].中华医学杂志,2008,88(11)：727-729.
[12]Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia:current concepts[J]. Am J Obstet Gynecol,1998,179:1359-1375.
[13]苟文丽,妊娠期高血压疾病[M]//乐杰.妇产科学(第七版),北京：人民卫生出版社,2008：92-99.
[14]Austgulen R, Isaksen CV, Chedwick L,et al.Craven C. Preeclampsia:associated with increased syncytial apoptosis when the infant is small-for-gestational-age[J]. J Reprod Immunol.2004,61:39-45.
[15]Crocker IP, Cooper S, Ong SC, et al. Differences in apoptotic susceptibility of cytotrophoblasts and syncytiotrophoblasts in normal pregnancy to those complicated with preeclampsia and intrauterine growth restriction[J]. Am J Pathol,2003,162:637-643.
[16]Sargent IL, Germain SJ, Sacks GP, Kumar S, Redman CW. Trophoblast deportation and the maternal inflammatory response in pre-eclampsia[J]. J Reprod Immunol,2003; 59: 153-60
[17]Johansen M, Redman CW, Wilkins T, et al.Trophoblast deportation in human pregnancy--its relevance for pre-eclampsia[J]. Placenta,1999;20:531-539.
[18]杨孜.早发型重度先兆子痫一产科医生面临的挑战[J].中国妇产科临床杂志,2003,4(2)：83-84.
[19]Goswami D, Tannetta DS, et al.Excess syncytiotrophoblast microparticle shedding is a feature of early-onset pre-eclampsia, but not normotensive intrauterine growth restriction[J]. Placenta.2006;27(1):56-61.
[20]Sitras V,Paulssen RH,et al.Differential Placental Gene Expression in Severe Preeclampsia [J].placenta.2009.30(5):424-433.
[21]李志杰,张文真,胡建秀,胎盘及外周血中STBM与早发型重度子痫前期病因的研究[J].实用妇产科杂志,2008,24(11)：677-681.
[22]Shenhav S,Gemer O,Soon E,et al.Mid-trimester tirplestlevels in early and lati-onset severe preeclampsia[J].prenat Diagn,2002,22(7):579-582.
[23]Egbor M, Ansari T, Morris N, et al.Morphometric placental villous and vascular abnormalities in early-and late-onset pre-eclampsia with and with-out fetal growth restriction[J].Br J Obstet Gynaecol,2006,113 (5):580-589.
[24]Rasm,IrgensLM.Fetal growth and body proportion in preeclampsia[J]ObstetGynecol,2003, 101(3):575-583.
[25]杨孜,王伽略,黄萍,等.重度子痫前期终末器官受累不平行性及其围产结局探讨[J].中华围产医学杂志,2006,9(9)：10-14.
[26]凌婉文,林建华,林其德等.妊娠期高血压疾病凝血相关指标的变化[J].上海交通大学学报·医学版,2008,28(1)：77-79.
[27]张新艳,姚元庆.早发型重度子痫前期相关问题[J].中国实用妇科与产科杂志,2009,25(4)：243-245.
[28]乔福元,妊娠期高血压疾病[M]//谢幸,孔北华.妇产科学,北京：人民卫生出版社,2007：104-112.
[29]Bianco A, Stone J, Lynch L, et al. Pregnancy outcome at age 40 and older[J].Obstet Gynecol,1996,87:917-922.
[30]Saftlas AF, Olson DR, Franks Al,et al. Epidemiology of preeclampsia and eclampsia in the United states,1979-1986[J]. Am J Obstet Gynecol,1990,163:460-465.
[31]彭波,袁秀琴.妊娠高血压综合征危险因素的Meta分析[J].南华大学学报·医学版,2009,37(2)：144-149.
[32]冯启明,李慕军,黄星,等.妊娠高血压综合征危险因素的Logistic回归分析[J].广西医科大学学报,2004,21(3)：325-327.
[33]雷玉秀,李凤莲,王玉梅.妊娠高血压综合征13年发病规律及相关因素病例对照分析[J].中国妇幼保健,2007,22(28)：3943-3945.
[34]Kurki T, Hiilesmaa V, Raitasalo R, et al. Depression and anxiety in early pregnancy and risk for preeclampsia[J]. Obstet Gynecol,2000,95(4):487-490.
[35]卫关华.妊高征的社会心理因素及预防措施[J].中华中西医学杂志,2004,2(10)：16-18.
[36]Qiu C, Williams MA, Calderon-Margalit R, etal.Preeclampsia Risk in Relation to Maternal Mood and Anxiety Disorders Diagnosed Before or During Early Pregnancy [J].Am J Hypertension,2009,22(4):397-402.
[37]尹春艳,张翠琼等,婚姻质量与妊娠期高血压疾病的相关性研究[J],南方医科大学学报2007,27(11)：1674-1676.
[38]TK Sorensen, MA Williams, I Lee,et al. Recreational Physical Activity During Pregnancy and Risk of Preeclampsia[J].Hypertension,2003,41:1273-1280.
[39]Magnus P, Trogstad L, et al.Recreational Physical Activity and the Risk of Preeclampsia: A Prospective Cohort of Norwegian Women[J].American Journal of Epidemiology,2008 168(8):952-957.
[40]黄萍,杨孜等,重度子痫前期191例严重并发症的监测[J].中国实用妇科与产科杂志,2006,22(11)：828-831.
[41]杨湘军,李娜等,重度子痫前期患者的分娩时机及方式探讨[J].中国妇幼保健,2008,23(1)：35-36.
[42]任景慧,徐宏里,林琳华,等.630例孕妇孕前孕早期保健状况分析[J].中国实用妇科与产 科杂志,2000,16(10)：635-636.
[43]张泽峰,蓝绍颖,储海涛等.我国甲类农村地区孕产妇产前检查次数方案效果评价[J].南通医学院学报,1998,18(3)：305-306.
[44]Lee CJ, Hsieh TT, Chiu TH, et al. Risk factors for pre-eclampsia in an Asian population[J]. Int J Gynecol Obstet,2000,70:327-333.
[45]Agustin Conde-Agudelo, JosC MB. Risk factors for pre-eclampsia in a large cohort of Latin American and Caribbean women[J]. BJOG,2000,107(1):75-83.
[46]Skjaerven R, Wilcox AJ, Lie RT. The interval between pregnancies and the risk of preeclampsia[J]. N Engl J Med,2002;346(1):33-38.
[47]Olga Bassol,2, Clarice R. Weinberg3,et al.Subfecundity as a Correlate of Preeclampsia:A Study within the Danish National Birth Cohort[J], Am J Epidemiol,2003; 157:195-202.
[48]L Trogstad, P Magnus, A Moffett,etal.The effect of recurrent miscarriage and infertility on the risk of pre-eclampsia[J].BJOG,2009,116(1):108-13.
[49]Makkonen N, Heinonen S, Kirkinen P. Obstetric prognosis in second pregnancy after preeclampsia in first pregnancy [J]. Hypertens Pregnancy,2000,19:173-181.
[50]Dukler D, Porath A, Bashiri A, et al. Remote prognosis of primiparous women with preeclampsia[J]. Eur J Obstet Gynecol Reprod Biol,2001;96:69-74.
[51]Chesley LC, Annitto JE, Cosgrove RA. The remote prognosis of eclamptic women. Sixth periodic report[J].Am JObstetGynecol,2000,182(1Pt1):247-248.
[52]Lykke JA, Langhoff-Roos Jens, Sibai BM,et al. Hypertensive disorders in pregnancy, recurrence in a second pregnancy, and subsequent cardiovascular events [J]. Am J Obstet Gynecol,2008,199(6):S6.
[53]Sonia Hernandez-Diaz, Sengwee Toh, Sven Cnattingius.Risk of pre-eclampsia in first and subsequent pregnancies:prospective cohort study[J].BMJ,2009,338:b2255.
[54]Salonen RH,Lichtenstein P.Genetec effects on the liability of developing preeclampsia and . gestional hypertension[J]. Am J Med Genet,2000,91(4):256-260.
[55]Skj(?)rven R,Vatten LJ,Wilcox AJ,et al.Recurrence of pre-eclampsia across generations: exploring fetal and maternal genetic components in a population based cohort[J]. BMJ, 2005,331:877.
[56]Sibai BM, Lindheimer M, Hauth J, et al. Risk factors for preeclampsia, abruptio placentae, and adverse. neonatal outcomes among women with chronic hypertension[J]. New Engl J Med (1998) 339:667-671.
[57]Caritis S, Sibai B, Hauth J, et al. Low-dose aspirin to prevent preeclampsia in women at high risk. National Institute of Child Health and Human Development Network of Maternal-Fetal Medicine Units[J]. New Engl J Med,1998,338:701-705.
[58]Catov JM, Ness RB, Kip KE, et al. Risk of early or severe pre-eclampsia related to pre-existing conditions [J]. Int J Epidemiology,2007,36(2):412-419.
[59]于红,魏玮,沈杨等.子痫前期高危因素的Logistic回归分析[J].实用妇产科杂志2010,26(4)：273-275.
[60]Rigo J, BozeT, DerzsyZ, et al.Family history of early-onset cardi-ovascular disorders is associated with a higher risk of severe pre-eclampsia[J]. Eur J ObstetGynecolReprod Bio,l 2006,128(1):148-151.
[61]Chunfang Q, Michelle A. et al.Family History of Hypertension and Type 2 Diabetes in Relation to Preeclampsia risk[J].Hypertension,2003,41:408-413.
[62]LeungTY, LeungTN, Sahota DS, et al,Trends inmaternal obesity and associated risks of adverse pregnancy outcomes in a population of Chinesewomen [J].BJOG,2008,115(12): 1529-1537.
[63]Frederick IO, RudraCB, MillerRS. Adultweight change, weight cycling, and prepregnancy obesity in relation to risk ofpreeclamp-sia[J]. Epidemiology,2006,17(4):428-434.
[64]Sebire NJ, Harris J, Regan L, et al. Is maternal underweight really a risk factor for adverse pregnancy outcome? A population-based study in London[J].Br J Obstet Gynaecol, 2001,108:61-66.
[65]Lykke JA, Langhoff-Roos Jens, Sibai BM,et al. Hypertensive pregnancy disorders and subsequent cardiovascularmorbidity and type 2 diabetesmellitus in the mother[J]. Hypertension,2009,53(6):944-951.
[66]Ray J, Diamond P, Singh G, et al. Brief overview of maternal triglycerides as a risk factor for pre-eclampsia[J]. BJOG 2006; 113:379-386.
[67]Themn GB,Thompson ML The usefulness of a weight gain spurt to identify women who will develop preeclampsia[J].Eur J Obstet Gynecol Reprod Biol,1998,78:47-51.
[68]吏峻梅,杨孜等.重度子痫前期患者临床发病前预警信息分析[J].中华妇产科杂志,44(5)：337-340.
[69]朱玉莲,田红菊等.妊娠高血压综合征相关危险因素的研究[J].医学临床研究,2005,22(12)：1747-1748.
[70]Duckitt K, Harrington D. Risk factors for pre-eclampsia at antenatal booking:systematic review of controlled studies[J]. BMJ,2005;330:549-50.
[71]雷马香,刘筱娴.妊娠高血压疾病危险因素的病例对照研究[J].中国社会医学杂志2009,26(3)：177-179.
[72]Zhou B, Zhang X, Zhu A, et al.The relationship of dietary animal protein and electrolytes to blood pressure:a study on three Chinese populations[J]. Int J Epidemiol. 1994,23(4):716-22.
[73]赵文华,王军波等.膳食及营养因素对农村居民高血压患病影响的多因素分析[J].营养学报,2002,24(3)：274-277.
[74]刘爱玲.甘肃省定西市贫困农村居民膳食与继发性高血压病相关调查分析[J].甘肃中医学院学报,2010,27(2)：79-80.
[75]Brantsaeter AL, Haugen M, Samuelsen SO, et al.A dietary pattern characterized by high intake of vegetables, fruits, and vegetable oils is associated with reduced risk of preeclampsia in nulliparous pregnant Norwegian women[J].J Nutr.2009,139(6):1162-8.
[76]Longo-Mbenza B, Tshimanga KB, Buassa-bu-Tsumbu B, et al.Diets rich in vegetables and physical activity are associated with a decreased risk of pregnancy induced hypertension among rural women from Kimpese, DR Congo [J].Niger J Med, 2008,17(3):265-9.
[77]Garratt FN.Pre-eclampsia:a challenge to public health teams worldwide to ensure that maternal diets contain adequate levels of folic acid, n3 polyunsaturated fatty acids and vitamin D at conception[J].Public Health,2009,123(1):95-6.
[78]丁新,黄醒华.妊娠高血压综合征患者的营养代谢状况[J].当代医学(学术版)2008,1：6-9.
[79]Holmes VA, McCance DR. Could antioxidant supplementation prevent pre-eclampsia[J]. Proc Nutr Soc.2005;64(4):491-501
[80]Lindheimer MD, Sibai BM.Antioxidant supplementation in. pre-eclampsia[J].The Lancet, 2006,367(9517):1119-1120.
[81]Beazley D, Ahokas R, Sibai BM,et al.Vitamin C and E supplementation in women at high risk for preeclampsia:a double-blind, placebo-controlled trial[J].Am J Obstet Gynecol, 2005,192:520-521.
[82]Poston L, Briley AL, Seed PT, et al. Vitamin C and vitamin E in pregnant women at risk for pre-eclampsia (VIP trial):randomised placebo-controlled trial[J]. Lancet; 2006;367: 1145-1154.
[83]Rumbold AR, Crowther CA, Haslam RR, et al. Vitamins C and E and the risks of preeclampsia and perinatal complication[J]. s. N Engl J Med,2006,354:1796-1806.
[84]Lisa M,Bodnar, Gong Tang, et al,Periconceptional Multivitamin Use Reduces the Risk of Preeclampsia[J]. American Journal of Epidemiology,2006,164(5):470-477.
[85]Janet M,Ellen A,et al.Association of periconceptional Mutivitamin Use With Reduced Risk of preeclampsia Among Normal-Weight Weight Women in the Danish National Birth Cohort[J].Am J Epidemiol,2009,169:1304-1311.
[86]Punthumapol C,et al.Serum calcium, magnesium and uric acid in preeclampsia and normal pregnan[J].J Med Assoc Thai.2008,91(7):968-73.
[87]Apostol A, Apostol R, et al.Cerebral spinal fluid and serum ionized magnesium and calcium levels in preeclamptic women during administration of magnesium sulfate[J].Fertil Steril,201094(1):276-282.
[88]Hofmeyr GJ, et al.Dietary calcium supplementation for prevention of pre-eclampsia and related problems:a systematic review and commentary[J].BJOG,2007,114(8):933-43.
[89]高树生,李黎,潘兴华.妊娠高血压综合征血浆叶酸同型半胱氨酸和内皮素浓度变化[J].中国实用妇科与产科杂志,2002,18(2)：86-88.
[90]Georgios M, Alexis P, Areti H,et al. Homocysteine, folic acid and B12 serum levels in pregnancy complicated with preeclampsia[J].Arch Gynecol Obstet,2007,275:121-124.
[91]Leeda M, Riyazi N, de Vries J, et al. Effects of folic acid and vitamin B6 supplementation on women with hyperhomocysteinemia and a, history of preeclampsia or fetal growth restriction[J]. Am J Obstet Gynecol,1998;179:135-139.
[92]Woo KS, Chook P, Lilin YI, et al. Folic acid improves arterial endothelial function in adults with hyperhomocysteinemia[J]. J Am Coll Cardiol,1999;34(7):2002-2006.
[93]Wen SW, Chen X-K, Rodger M, et al. Folic acid supplementation in early second trimester and the risk of preeclampsia[J]. Am J Obstet Gynecol,2008,198:45.e1-45.e7.
[94]李智慧.口服小剂量叶酸预防妊娠高血压疾病的临床研究[J].吉林医学,200930(15)：1678-1679.
[95]Oken E, Ning Y, Rifas-Shiman SL, et al.Diet During Pregnancy and Risk of Preeclampsia or Gestational Hypertension[J].Ann Epidemiol,2007,17(9):663-668.
[96]陈春明.防治肥胖刻不容缓[J].中华预防医学杂志,2001,35(5)：291-292·
[97]张文彤主编.世界优秀统计工具SPSS 11.0统计分析教程(高级篇)[M].北京希望电子出版社,2004,82-83.
[98]万淑梅,余艳红,黄莺莺.妊娠期高血压疾病严重并发症的发生规律及其对母儿的影响[J].中华妇产科杂志,2007,42(8)：510-514.
[99]熊波,晏元辉.妊娠高血压疾病患者生活质量及社会支持调查[J].中国现代医生,2010,48(19)：58-59.
[100]罗聪,刘莉雁.高血压病与ABO血型关系流行病学调查研究[J].吉林大学学报(医学版),1989(2)：143-144.
[101]陈少华,陈爱国,冯福英.ABO血型与高血压、糖尿病及哮喘的相关性探讨[J].中国优生与遗传杂志,2003,11(6)：139-140.
[102]代炳梅,隗伏冰李巧仪.早发型重度子痫前期的临床特点分析[J].中国现代医生,2008,46(18)：26-29.
[103]Knivat M.Eclampsia in the United Kingdom 2005[J].BJOG,2007,114(9):1072-1078.
[104]E B Magnussen, L J Vatten.Prepregnancy cardiovascular risk factors as predictors of pre-eclampsia:population based cohort study[J].BMJ 2007,335(7627):945-946.
[105]Sibai BM, DekkerG, KupfermincM. Pre-eclampsia[J]. Lancet,2005,365(9461):785-799.
[106]杨孜,王伽略.子痫前期临床防范和处理关键点[J].实用妇产科杂志,2010,26(1)：4-7.
[107]Lill Trogstad,Per Magnus, et al, Previous abortions and risk of pre-eclampsia[J]. International Journal of Epidemiology,2008,37(6):1333-1340.
[108]倪帼华,丁惠群.妊娠高血压综合征的影响因素研究[J].中国妇幼保健,2006,21(5)：621-622.
[109]Takiuti NH, Kahhale S, Zugaib M, et al.Stress in pregnancy:a new Wistar rat model forhuman preeclampsia[J]. Am J Obstet Gynecol.2002;186(3):544-550.
[110]洪照光.生活方式与高血压病[J].临床内科杂志,1999,16(1)：1-3.
[111]Weissgerber TL,Wolfe LA,Davies GA. the role of regular physica-lactiv ity in preeclampsia prevention [J]. Med Sci Sports Exerc,2004,36 (12):2024-2031.
[112]Tanya K,Sorensen, et al.Recreational Physical Activity During Pregnancy and Risk of Preeclampsia[J]. Hypertension,2003,41:1273-1280.
[113]孙敏娜,马瑞琼,杨孜.高脂饮食对apoE-/-子痫前期样改变孕鼠血脂和妊娠结局影响研究[J].中华医学杂志,2010,90(19)：1342-1347.
[114]刘小清,饶栩栩,李义和等.利用食物频数法对广东三个人群进行膳食分析[J].岭南心血管病杂志,1997,3(3)：1-3.
[115]Sanrelainen H,Laitinen T,Raitakari OT, et al.Pregnancy-related hyperlipidemia and endothelial function in healthy women[J].Circ J.2006,70(6)-768-772.
[116]王伽略,杨孜等,子痫前期患者血脂代谢调节的探讨[J].现代妇产科进展,2006,15(6)：438-441.
[117]Lam C, Lim KH, Kang DH,et al. Uric acid and preeclampsia[J]Semin Nephrol.2005, 25(1):56-60.
[118]James M,Janet M,Preeclampsia More Than 1 Disease Or Is It? [J]. Hypertension,2008, 51:989-990.