تغییرات فصلی در بروز پره اکلامپسی و عوامل خطر آن

نوع مقاله: اصیل پژوهشی

نویسندگان

1 کارشناس پرستاری، کمیته تحقیقات دانشجویی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

2 استادیار گروه پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی مازندران، ساری، ایران.

3 دانشجوی دکترای پرستاری، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: اختلالات فشار خون در دوران بارداری باعث عوارضی جدی از جمله خونریزی و عفونت می شود که زمینه افزایش مرگ و میر را به همراه دارد. همچنین در برخی مطالعات انجام شده ارتباط بین تنوع فصلی و وقوع پره اکلامپسی گزارش شده است. مطالعه حاضر با هدف بررسی ارتباط الگوهای فصلی با پره اکلامپسی انجام شد.
روش کار:این مطالعه مورد شاهدی بین سال های 92-1388 بر روی 455 زن باردار (205 نفر مبتلا و 250 نفر فاقد پره اکلامپسی) که بعد از هفته 20 بارداری به زایشگاه بیمارستان امام علی (ع) شهر آمل مراجعه کرده بودند، انجام شد. داده هایی نظیر مشخصات فردی و سابقه بیماری مادران از پرونده های پزشکی موجود در بایگانی بیمارستان جمع آوری شد. تجزیه و تحلیل داده ها با استفاده از نرم افزار آماریSPSS  (نسخه 20) و آزمون های کای دو، آزمون دقیق فیشر، من ویتنی یو، رگرسیون لوجستیک ساده و چندگانه (تعدیل شده) انجام شد. میزان p کمتر از 05/0 معنی دار در نظر گرفته شد.
یافته ها: بیشترین میزان بروز پره اکلامپسی در فصل پاییز (21/31%) و بعد از آن در فصل زمستان (78/28%) بود. بر اساس نتایج آزمون کای دو، بین بروز پره اکلامپسی با سابقه سقط، دیابت، فشار خون و زایمان دو قلویی ارتباط معناداری وجود داشت (05/0>p). همچنین بر اساس نتایج آزمون من ویتنی یو، در گروه پره اکلامپسی، میانگین سن مادر00/6±61/28 سال، سن بارداری 50/3±75/35 هفته و وزن نوزاد 28/841± 73/2600 گرم بود که تفاوت آماری معناداری با زنان سالم داشت (05/0>p).
نتیجه گیری: درک ارتباط بین الگوهای مختلف آب و هوایی و ابتلاء به پره اکلامپسی می تواند در شناخت عوامل محرک ابتلاء به پره اکلامپسی مفید باشد. همچنین نتایج این مطالعه می تواند به برنامه ریزی جهت انجام اقدامات پیشگیرانه و درمانی به موقع زنان باردار مستعد کمک کند و عوارض جدی که مادر و جنین را تهدید می کند، کاهش دهد.

کلیدواژه‌ها


عنوان مقاله [English]

Association between seasonal patterns and preeclampsia

نویسندگان [English]

  • samaneh Shahidifar 1
  • Hamid Sharifnia 2
  • Behzad Taghipoor 1
  • Mitra Hekmat Afshar 3
  • Reihaneh Motevalli 1
  • Yoones khalili 1
  • Fahime Mazraie 1
1 Nursing graduate, Student research committee, School of Nursing and midwifery, Mazandaran University of Medical sciences, Sari, Iran.
2 Assistant Professor, Department of nursing and midwifery, School of Nursing and midwifery, Mazandaran University of Medical Sciences, Sari, Iran
3 PhD student of nursing, School of Nursing and midwifery, Shahid Beheshti university of medical sciences, Tehran, Iran.
چکیده [English]

Introduction: Hypertensive disorders in pregnancy lead to serious complications such as bleeding and infection that is associated with increased mortality. This study was performed with the aim of evaluating the association between seasonal patterns and preeclampsia
Methods: This case-control study was performed on 455 pregnant women (205 with preeclampsia and 250 without preeclampsia) who had referred to the maternity of Amol Imam Ali hospital after 20 weeks of gestation from 2008-2013. Data such as demographic characteristics and history of mothers' disease were collected from medical records on file available in the hospital. Data analysis was performed with SPSS software (version 20) and Chi-square, Fisher's exact, Mann–Whitney U tests, simple and multiple logistic regression. PResults: the highest incidence of preeclampsia was in the fall (31.21%) and then in the winter (28.78%). Chi-square test results showed that there was significant relationship between preeclampsia and the history of abortion, diabetes, hypertension and twin pregnancy (P<0.05). Also, Mann–Whitney U results showed that the mean maternal age was 28.61±6.00 years, gestational age 35.75±3.50, and birth weight 2600.73±841.28 in mothers with preeclampsia which were significantly different with healthy women.(p<0/05)
Conclusion: Understanding the relationship between different weather patterns and preeclampsia can be useful in identifying triggers of the risk of preeclampsia. Also, the results of this study can help to design the plans to perform preventive and treatment measures in susceptible pregnant women and decrease serious complications which threaten the mother and fetus.

کلیدواژه‌ها [English]

  • Preeclampsia
  • pregnancy
  • Rick Factors
  • Season
  1. Allahyari E, Rahimifrushani A, Zeraati H, Mohammad K, Taghizadeh Z. Making a model for soon predicting preeclampsia JOURNAL OF REPRODUCTION AND INFERTILITY Journal of Tehran Medical Science University 2010; 10(4):261-267.
  2. Cuningham F, Bloom SL, Hauth JC, Gilstrap LK, Wenstrom KD. Pregnancy hypertensionWilliams obstetrics. 23nded. New York:Mcg raw hill pub; 2010. p.706.
  3. Vahidroodsari F, Ayati S, Ebrahimimonfared M. Before pregnancy BMI effect on incident of pregnancy blood pressure and preeclampsia. Journal of Babol Medical Science University 2009; 11(4): 49-53.
  4. Ali mohammadi R, kashanian M, baradaran HR. Survey on some risk factor for preeclampsia outbreak. Razi Journal of Medical Sciences 2008; 59(15):131-136.
  5. Nasrollahi SH, Mohammadi A, Zamani M. Antioxidants (vit C &E) effect in decreasing rate of preeclampsia prevalence in nuliparous women. Scientific Journal of Gorgan University of Medical Siences 2006; 8(1) pp: 17-21.
  6. Safari M, Yazdanpanah B. Preeclampsia and maternal and fetal side effects prevalence in women visiting maternity of Yasuj Imam sajjad hospital ,Journal Of Shahrekord University of medical Sciences 2003; 5(2):47-53.
  7. Khojasteh F, Safarzadeh A, Burayri T. Survey on correlation between preeclampsia with season and some it`s risk factors in pregnant women. Women’s Health Care 2012; 3(1): 79-84.
  8. Duley L. The Global Impact of Pre-eclampsia and Eclampsia. Seminars in Perinatology 2009; 33(3):130-7
  9. Broughton Pipkin F.  Risk factors for preeclampsia. The New England Journal of Medicine 2001; 344(12):925-6.
  10. Shakeri M, Saeedi N. Survey on effect of vitamin C in prevention of preeclampsia prevalence in nuliparous women   Medical Sciences Journal of Islamic Azad Univesity 2009; 18(1): 29-31.
  11. Vikse BE, Lorentz M, Irgens, Torbjorn Leivestadb Rolv Skjarven and Bjarne M. Iversen. Preeclampsia and the Risk of End-Stage Renal Disease. New England Journal of Medicine ( 2008; 359(8):800-9
  12. Bouzari Z, Yazdani S, Haghshenas , Javadian M. shirkhanikolahgary Z, Memarian M. Comparison between pregnancy and fatal feedback in people with HELLP syndrome with preeclampsia. Journal of Babol Medical Science University 2011; 13(6):52-8.
  13. Hekmatafshar M, Joubary L, Saeedi E. Intracerebral hemorrhage in pregnant woman with preeclampsia. Jentashapir Journal (JJHR) 2010; 1(1):50-56
  14. Jafarnejad F, Nasrollahi S, Yousefi R. Survey on none-preservative intercourse relationship and preeclampsia. Science and research journal of Mashhad nursing and obstetrics college 2009; 9(2):95-9.
  15. Agha Mohammadi A, Nooritajer M, Kheirkhah M. Pregnancy backwash comparison between nuliparous women more and lesser than 35 years old. Nursing and obstetrics issue , IRAN Journal of Nursing 2010; 63(23):69-77.
  16. Shojaeean Z, Sadeghianharat R, negahban Z. Survey on prediction value of Hb and HCT rate in second three month pregnancy for preeclampsia diagnosis. The Iranian Journal of Obstetrics, Gynecology and Infertility Unit 2009;12(4) pp: 13-17
  17. Nasiriamiri F, Aghajanidelavar M. Mohammadpourtahmtan RA. Survey on mean arterial pressure diagnostic value in second three month pregnancy in preeclampsia prediction. The Journal of Mazandaran University of Medical Sciences 2009; 45(14):67-73.
  18. Magnus P, Eskild A. Seasonal variation in the occurrence of pre-eclampsia. British Journal of Obstetrics and Gynecology 2001; 108(11):1116–1119.
  19. Philips JK, Bernstein M,  Mongeon JA, Badger GJ. Seasonal Variation in Preeclampsia Based on Timing of Conception. The American College of Obstetricians and Gynecologists 2004; 104(5 Pt1):1015-20.
  20. Zahirisoroori Z, shahrami H, Faraji R. Seasonal variation of the onset of preeclampsia and eclampsia. Journal of Research Medicine Science 2007; 12(4):198-202
  21. Subramaniam V. Seasonal variation in the incidence of preeclampsia and eclampsia in tropical climatic conditions. BMC Women's Health. 2007;7(1):18.
  22. Westerterp KR, Plasqui G, Goris AH. Water loss as a function ofenergy intake, physical activity and season. Br J Nutr 2005; 93(2):199-203.
  23. .Wellington K, MullaZd. Seasonal Trend in the Occurrence of Preeclampsia and Eclampsia in Texas. American Journal of Hypertension. 2012;25(1):115-9
  24. Shental O, Friger M, Sheiner E. Ethnic differences in the monthly variation of preeclampsia among Bedouin and Jewish parturients in the Negev. Hypertension in Pregnancy 2010;29(3):342-9.
  25. Rylander A, Lindqvist PG. Eclampsia is more prevalent during the winter season in Sweden. ActaObstetricia ET GynecologicaScandinavica 2011; 90(1):114-117
  26. Mostello D, Kallogjeri D, Tungsiripat R, Leet T. Recurrence of preeclampsia: effects of gestational age at delivery of the first pregnancy, body mass index, paternity, and interval between births. American Journal of Obstetrics and Gynecology 2008;199(1):55. e1-7.
  27. Alkaff T, S Hartini T, Hakimi M. Relationship of the seasonal variations with          the incidence of preeclampsia Dr. Sardjito, General Hospital Yogyakarta, 1999-2003. Indonesian Journal of Obstetrics and Gynecology 2011; 32(3): 139-42.
  28. Shiozaki A, Matsuda Y, Satoh S, Saito S. Comparison of risk factors for gestational hypertension and preeclampsia in Japanese singleton pregnancies. Journal of Obstetrics and Gynaecology Research 2013; 39(2):492-9
  29. Lecarpentier E, Tsatsaris V, Goffinet F, Cabrol D, Sibai B, Haddad B. Risk Factors of Superimposed Preeclampsia in Women with Essential Chronic Hypertension Treated before Pregnancy. PloS one 2013; 8(5): e62140.
  30. Mosayebi Z, Fakhraee SH, Movahedian AH. Prevalence and Risk Factors of Low Birth Weight Infants in MahdiehMatenity Hospital, Tehran for One Year. Feiz 2004; 8(2):65-70.