ШЫҒЫС ҚАЗАҚСТАН ОБЛЫСЫ, СЕМЕЙ ҚАЛАСЫНДАҒЫ ЖҮКТІЛЕРДЕ ПРЕЭКЛАМПСИЯНЫҢ ПАЙДА БОЛУ ФАКТОРЛАРЫН АНЫҚТАУ
Кіріспе. Жүктіліктің кез келген мерзімінде пайда болатын мультифакторлы және ұзақ жүретін процестердің бірі - преэклампсия мен эклампсия. Мақсаты. Преэклампсияның предикторын анықтау мақсатында зерттеуге Семей қаласының тұрғындары алынды. Материалдар мен әдістер. Бақылаушы когорттық зерттеу. Зерттеуге айқындалған акушерлік анамнезі бар әйелдер алынды. Көрсеткіштер абсолютті сандармен және пайызбен, сондай-ақ орташа және оның 95% сенімділік интервалымен және стандартты ауытқумен көрсетілген. Гипотизадағы айнымалылар арасындағы статистикалық байланысын тексеру үшін Пирсонның Хи-квадрат критерий (2) қолданылды. Нәтижелері. Жүктіліктің орташа мерзімі 38,3 (±3,61) апта болды. Преэклампсия 3,2% (n=6) зерттеушілерде болса, олардың орташа 34,3 (±3,72)жасты құрады. Зерттеу барсында жас (p=0,015), ұлты (p=0,046), созылмалы артериялық гипертензия (p=0,001), жүктілік арасындағы интервал (p=0,034), анамнезінде «Допегит» препаратын қолдану (p=0,014) және преэклампсияның дамуы арасындағы статистикалық маңыздылығы анықталынды. Қорытынды. Семей қаласының тұрғындарында перэклампсияның пайда болуына әсер ететін негізгі фактор болып жас ерекшелгі, ұлты, преклампсия, гестациялық артериялды гипертензия немесе анамнезінде эклампсияның болуы, соңғы жүктілік арасындағы интервал, анамнезінде допегит қолдануы болды.
Алима С. Нургазина 1, https://orcid.org/0000-0003-1023-8496 Надира С. Сләмханова 1, https://orcid.org/0000-0003-3874-1309 Гульнар М. Шалгумбаева 1, http://orcid.org/0000-0003-3310-4490 1 «Семей медицина университеті» ҚеАҚ, Семей қаласы, Қазақстан Республикасы
1. Айламазян Э.К., Мозговая Е.В. Гестоз: теория и практика. М.: МЕД пресс-информ, 2008. 272 с. 2. Верткин А.Л., Ткачева О.Н., Мурашко Л.Е. и др. Артериальная гипертония беременных: диагностика, тактика ведения и подходы к лечению // Лечащий врач. 2006. № 3. С. 25-8. 3. Курочка М.П. Анализ факторов риска преэклампсии и эклампсии в случаях материнских смертей // Саратовский научно-медицинский журнал. 2013. Т. 9, №2. С. 230–234. 4. Макацария А.Д., Бицадзе В.О., Акиньшина С.В. Синдром системного воспалительного ответа в акушерстве. М.: МИА, 2006. 448 с. 5. Манухин И.Б., Маркова Е.В., Маркова Л.И., Стрюк Р.И. Комбинированная низкодозовая антигипертензивная терапия у беременных с артериальной гипертонией и гестозом // Кардиология. 2012. № 1. С.32–38 6. Нецеевская М.А. Клинико-иммунологические критерии прогнозирования гестоза: дис…. канд. мед. наук. Москва, 2000. 234 с. 7. Пестрикова Т.Ю.,. Блощинская И.А, Юрасова Е.А., Витько Н.Ю. Патогенетические аспекты гестоза у беременных с воспалительной патологией гениталий // Проблемы беременности. 2001. № 3. С. 57–58. 8. Репина М.А. Преэклампсия и материнская смертность. СПб.: МАПО, 2005. 208 с. 9. Сидорова И.С. Гестоз. М.: Медицина, 2003. 416с. 10. Сухих Г.Т., Мурашко Л.Е. Преэклампсия. М.: ГЭОТАР Медиа, 2010. 576 с. 11. Abalos E., Duley L., Steyn D.W. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy // Cochrane Database Syst Rev 2014; (2):CD002252. 12. Al-Maawali A., Walfisch A., Koren G. Taking angiotensinconverting enzyme inhibitors during pregnancy: is it safe? // Can Fam Physician 2012;58(1):49-51 13. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy // Obstet Gynecol. 2013;122(5):1122-31. Available at: https://www.acog.org/~/media/Task%20Force%20and%20Work%20Group%20Reports/public/Hypertension in Preg nancy.pdf (дата обращения: 15.08.2018) 14. American College of Obstetricians and Gynecologists. Preeclampsia and high blood pressure during pregnancy [Internet]. Available at: https://www.acog.org/Patients/FAQs/ Preeclampsia-and-High-Blood-Pressure-During- Preg nancy [cited 2017.10.17] 15. Ananth C.V., Keyes K.M., Wapner R.J. Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis // Br Med J. BMJ. 2013 Nov 7; 347: f6564. PubMed | Google Scholar 16. Astolfi P., Zonta L.A. Delayed maternity and risk at delivery // Paediatr Perinat Epidemiol. 2002;16:67–72. 17. Backes C.H., Markham K., Moorehead P., Cordero L., Nankervis C.A., Giannone P.J. Maternal preeclampsia and neonatal outcomes. // J Pregnancy;2011:214365 18. Baragoua S., Goeh-Akueb E., Piob M., Afassinoub Y.M., Attaa B. Hypertension and pregnancy in Lome (sub-Saharan Africa): Epidemiology, diagnosis and risk factors // Ann Cardiol Angeiol. 2014; 63(3):145-150.PubMed | Google Scholar 19. Bartsch E., Medcalf K.E., Park A.L., Ray J.G. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies // Br Med J. 2016 Apr 19; 353: i1753. PubMed | Google Scholar 20. Battin M., Sadler L., Australia, Network NZN. Neonatal intensive care utilization and neonatal outcome of infants born to women aged 40 years and over in New Zealand // Acta Paediatr. 2010; 99:219–24 21. Brown C.M., Garovic V.D. Drug treatment of hypertension in pregnancy. // Drugs 2014; 74 (3):283-96. 22. Carolan M. Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence. // Midwifery. 2013; 29:479–89. 23. Chen X.K., Wen S.W., Fleming N., Demissie K., Rhoads G.G., Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study // Int J Epidemiol. 2007; 36:368–73. 24. Clivaz Mariotti L., Saudan P., Landau Cahana R., Pechere–Bertschi A. Hypertension in pregnancy // Rev. Med. Suisse. 2007; 3(124): P. 2015–2016. 25. Curiel-Balsera E., Prieto-Palomino M.A., Mu'noz-Bono J., Ruiz de Elvira M.J., Galeas J.L., Quesada García G. Analysis of maternal morbidity and mortality among patients admitted to obstetric intensive care with severe preeclampsia, eclampsia or HELLP syndrome // Med Intensiva. 2011; 35(8): 478483. PubMed |Google Scholar 26. Dietl A., Cupisti S., Beckmann M.W., Schwab M., Zollner U. Pregnancy and obstetrical outcomes in women over 40 years of age // Geburtshilfe Frauenheilkd. 2015;75:827–32. 27. Gibbs C.M., Wendt A., Peters S., Hogue C.J. The impact of early age at first childbirth on maternal and infant health. // Paediatr Perinat Epidemiol. 2012; 26 (Suppl 1):259-84. 28. Goffinet F. Epidemiology // Ann Fr Anesth Reanim. 2010; 29(3): 7-12. [PubMed.] 29. Hamilton B.E., Martin J.A., Osterman M.J.K., Curtin S.C., Matthews T.J. Births: final data for 2014. // Natl Vital Stat Rep. 2015; 64:1–64 30. Harioly N., Rasolonjatovo T.Y., , Randriambololona A.M., Ranoaritiana D.B., Andrianjatovo J.J., Randriamiarana J.M. Profil épidémiologique des pré-éclampsies et des éclampsies admises à la réanimation des adultes de la maternité de Befelatanana // Rev Anest Réa Méd Urg. 2009; 1(3): 22-24. 31. Huang L., Sauve R., Birkett N., Fergusson D., van Walraven C. Maternal age and risk of stillbirth: a systematic review // CMAJ. 2008;178:165-72 32. Jolly M., Sebire N., Harris J., Robinson S., Regan L. The risks associated with pregnancy in women aged 35 years or older // Hum Reprod. 2000; 15:2433-7. 33. Kanungo J., James A., McMillan D., Lodha A., Faucher D., Lee S.K., et al. Advanced maternal age and the outcomes of preterm neonates: a social paradox? // Obstet Gynecol. 2011; 118:872-7. 34. Kenny L.C., Lavender T., McNamee R., O’Neill S.M., Mills T., Khashan A.S. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort // PLoS One. 2013;8:e56583. 35. Khalil A., Syngelaki A., Maiz N., Zinevich Y., Nicolaides K.H. Maternal age and adverse pregnancy outcome: a cohort study // Ultrasound Obstet Gynecol. 2013; 42:634–43. 36. Laopaiboon M., Lumbiganon P., Intarut N., Mori R., Ganchimeg T., Vogel J.P., et al. Advanced maternal age and pregnancy outcomes: a multicountry assessment // BJOG. 2014;121 (Suppl 1):49–56 37. Loghi M., Crialesi R. La salute riproduttiva della donna. Roma: Istituto Nazionale di Statistica. 2017. 115p. 38. Londero A.P., Bertozzi S., Fruscalzo A., Driul L., Marchesoni D. Ultrasonographic assessment of cervix size and its correlation with female characteristics, pregnancy, bmi, and other anthropometric features // Arch Gynecol Obstet. 2011; 283:545-50. 39. Londero A.P., Rossetti E, Pittini C., Cagnacci A., Driul L. Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study // BMC Pregnancy and Childbirth. 2019; 19:261 https://doi.org/10.1186/s12884-019-2400-x 40. Magee L.A., Ornstein M.P., von Dadelszen P. Fortnightly review: management of hypertension in pregnancy // BMJ. 1999; 318 (7194):1332-6 41. Malabarey O.T., Balayla J., Klam S.L., Shrim A., Abenhaim H.A. Pregnancies in young adolescent mothers: a population-based study on 37 million births // J Pediatr Adolesc Gynecol. 2012;25:98–102 42. Mulla Z.D., Nuwayhid B.S., Garcia K.M. et al. Risk factors for a prolonged length of stay in women hospitalized for preeclampsia in Texas // Hypertens Pregnancy. 2010; 29 (1): 54–68. 43. Muntner P., Bowling C.B., Shimbo D. Systolic blood pressure goals to reduce cardiovascular disease among older adults. // Am J Med Sci 2014;348 (2):129-34 44. Poon L.C., Shennan A, Hyett J.A., et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention // Int J Gynaecol Obstet 2019; 145 (suppl 1): 1–33. 45. Ramakrishnan A., Lee L.J., Mitchell L.E., Agopian A.J. Maternal hypertension during pregnancy and the risk of congenital heart defects in offspring: a systematic review and meta-analysis // Pediatr Cardiol 2015;36 (7):1442-51 46. Shan D., Qiu P.Y., Wu Y.X., Chen Q., Li A.L., Ramadoss S., et al. Pregnancy outcomes in women of advanced maternal age: a retrospective cohort study from China // Sci Rep. 2018; 8:12239 47. Sibai B.M. Chronic hypertension in pregnancy. // Obstet Gynecol. 2002; 100 (2):369-77. 48. Sibai B.M. Treatment of hypertension in pregnant women. // N Engl J Med 1996; 335 (4):257-65 49. Sibai B.M., Caritas S.N., Hauth J.C., MacPherson C., VanDorsten J.P., Klebanoff M., et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network // Am J Obstet Gynecol 2000; 183 (6):1520-4. 50. Sobotka T. Post-transitional fertility: childbearing postponement and the shift to low and unstable fertility levels. Vienna: Vienna Institute of Demography Working Papers 01/2017. 2017. 51. Wang Y., Tanbo T., Abyholm T., Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations // Arch Gynecol Obstet. 2011; 284:31–7. 52. Waters E.G., Wager H.P. Pregnancy and labour experiences of elderly primigravidas // J Mich State Med Soc. 1950; 49:435–9. 53. Winer N., Tsasaris V. État des connaissances: prise en charge thérapeutique de la pré-éclampsie // J Gynecol Obstet Biol Reprod. 2008; 37 (1): 5-15 References: 1. Ajlamazjan J. K., Mozgovaja E. V. Gestoz: teoriya i praktika [Gestosis: theory and practice]. Moscow: MED press-inform, Publ., 2008. 272 p. [in Russian] 2. Vertkin A.L., Tkacheva O.N., Murashko L.E. i dr. Arterialnaya gipertoniya beremennykh: diagnostika, taktika vedeniya i podkhody k lecheniyu [Arterial hypertension in pregnant women: diagnosis, management tactics and treatment approaches] Lechashhii vrach [Attending physician]. 2006, 3, pp. 25-8. [in Russian]. 3. Kurochka M. P. Analiz faktorov riska pree`klampsii i eklampsii v sluchayakh materinskikh smertej [Analysis of preeclampsia and eclampsia risk factors in cases of maternal death]. Saratovskii nauchno-meditszinskii zhurnal [Saratov Journal of Medical Scientific Research]. 2013. Vol. 9, № 2. pp. 230–234 [in Russian] 4. Makacarija A.D., Bicadze V.O., Akinshina S.V. Sindrom sistemnogo vospalitelnogo otveta v akusherstve [Syndrome of a systemic inflammatory response in obstetrics]. Moscow: MIA Publ., 2006. 448 p. [in Russian] 5. Manukhin I.B., Markova E.V., Markova L.I., Stryuk R.I. Kombinirovannaya nizkodozovaya antigipertenzivnaya terapiya u beremennykh s arterialnoj gipertoniej i gestozom [Combined low- dose antihypertensive therapy in pregnant women with arterial hypertension and gestosis]. Kardiologiya [Cardiology]. 2012, 1, pp.32–38 [in Russian] 6. Neceevskaja M. A. Kliniko-immunologicheskie kriterii prognozirovanija gestoza (avtoref. dis. kand. med. nauk). [Clinical and immunological criteria for predicting of gestosis. Diss of Cand of med scien]. Moscow, 2000. 34 p. [in Russian] 7. Pestrikova T.Ju., Bloshhinskaja I. A., Jurasova E. A., Vitko N. Ju. Patogeneticheskie aspekty gestoza u beremennyh s vospalitelnoj patologiej genitalij [Pathogenetic aspects of gestosis in pregnant women with inflammatory pathology of the genitals]. Problemy beremennosti [Pregnancy problems] 2001. № 3. P. 57–58. [in Russian] 8. Repina M.A. Preeklampsiya i materinskaya smertnost [Preeclampsia and maternal mortality]. SPb.: MAPO, Publ.2005. 208 p. [in Russian] 9. Sidorova I. S. Gestoz [Gestosis] Moscow: Medicina Publ., 2003. 416 p. [in Russian] 10. Suhih G.T., Murashko L.E. Preeklampsya [Preeclampsia] M.: GEOTAR-Media, 2010. 576 p. [in Russian] 11. Abalos E., Duley L., Steyn D.W. Antihypertensive drug therapy for mild to moderate hypertension during pregnancy. Cochrane Database Syst Rev. 2014; (2):CD002252. 12. Al-Maawali A., Walfisch A., Koren G. Taking angiotensinconverting enzyme inhibitors during pregnancy: is it safe? Can Fam Physician. 2012;58(1):49-51 13. American College of Obstetricians and Gynecologists; Task Force on Hypertension in Pregnancy. Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013;122(5):1122-31. Available at: https://www.acog.org/~/media/Task%20Force%20and%20Work%20Group%20Reports/public/Hypertension in Preg nancy.pdf (accessed: 15.08.2018) 14. American College of Obstetricians and Gynecologists. Preeclampsia and high blood pressure during pregnancy [Internet]. Available at: https://www.acog.org/Patients/FAQs/ Preeclampsia-and-High-Blood-Pressure-During- Preg nancy [cited 2017.10.17] 15. Ananth C.V., Keyes K.M., Wapner R.J. Pre-eclampsia rates in the United States, 1980-2010: age-period-cohort analysis. Br Med J. BMJ. 2013 Nov 7; 347: f6564. PubMed | Google Scholar 16. Astolfi P., Zonta L.A. Delayed maternity and risk at delivery. Paediatr Perinat Epidemiol. 2002;16:67–72. 17. Backes C.H., Markham K., Moorehead P., Cordero L., Nankervis C.A., Giannone P.J. Maternal preeclampsia and neonatal outcomes. J Pregnancy. 2011;2011:214365 18. Baragoua S., Goeh-Akueb E., Piob M., Afassinoub Y.M., Attaa B. Hypertension and pregnancy in Lome (sub-Saharan Africa): Epidemiology, diagnosis and risk factors. Ann Cardiol Angeiol. 2014; 63(3): 145-150.PubMed | Google Scholar 19. Bartsch E., Medcalf K.E., Park A.L., Ray J.G. Clinical risk factors for pre-eclampsia determined in early pregnancy: systematic review and meta-analysis of large cohort studies. Br Med J. 2016 Apr 19; 353: i1753. PubMed | Google Scholar 20. Battin M., Sadler L., Australia, Network NZN. Neonatal intensive care utilization and neonatal outcome of infants born to women aged 40 years and over in New Zealand. Acta Paediatr. 2010; 99:219–24 21. Brown C.M., Garovic V.D. Drug treatment of hypertension in pregnancy. Drugs. 2014; 74 (3):283-96. 22. Carolan M. Maternal age ≥45 years and maternal and perinatal outcomes: a review of the evidence. // Midwifery. 2013; 29:479–89. 23. Chen X.K., Wen S.W., Fleming N., Demissie K., Rhoads G.G., Walker M. Teenage pregnancy and adverse birth outcomes: a large population based retrospective cohort study. Int J Epidemiol. 2007; 36:368–73. 24. Clivaz Mariotti L., Saudan P., Landau Cahana R., Pechere–Bertschi A. Hypertension in pregnancy. Rev. Med. Suisse. 2007; 3(124): P. 2015–2016 25. Curiel-Balsera E., Prieto-Palomino M.A., Mu'noz-Bono J, Ruiz de Elvira MJ, Galeas JL, Quesada García G. Analysis of maternal morbidity and mortality among patients admitted to obstetric intensive care with severe preeclampsia, eclampsia or HELLP syndrome. Med Intensiva. 2011; 35(8): 478483. PubMed |Google Scholar 26. Dietl A., Cupisti S., Beckmann M.W., Schwab M, Zollner U. Pregnancy and obstetrical outcomes in women over 40 years of age. Geburtshilfe Frauenheilkd. 2015;75:827–32. 27. Gibbs C.M., Wendt A., Peters S. The impact of early age at first childbirth on maternal and infant health. Paediatr Perinat Epidemiol. 2012; 26 (Suppl 1):259-84. 28. Goffinet F. Epidemiology. Ann Fr Anesth Reanim. 2010; 29(3): 7-12. [PubMed.] 29. Hamilton B.E., Martin J.A., Osterman M.J., Curtin S.C., Matthews T.J. Births: final data for 2014. Natl Vital Stat Rep. 2015; 64:1–64 30. Harioly N., Rasolonjatovo T.Y., Randriambololona A.M., Ranoaritiana D.B., Andrianjatovo J.J., Randriamiarana J.M. Profil épidémiologique des pré-éclampsies et des éclampsies admises à la réanimation des adultes de la maternité de Befelatanana. Rev Anest Réa Méd Urg. 2009; 1(3): 22-24. 31. Huang L., Sauve R., Birkett N., Fergusson D., van Walraven C. Maternal age and risk of stillbirth: a systematic review. CMAJ. 2008;178:165-72 32. Jolly M., Sebire N., Harris J., Robinson S., Regan L. The risks associated with pregnancy in women aged 35 years or older. Hum Reprod. 2000; 15:2433-7. 33. Kanungo J., James A., McMillan D., Lodha A., Faucher D., Lee S.K., et al. Advanced maternal age and the outcomes of preterm neonates: a social paradox? Obstet Gynecol. 2011; 118:872-7. 34. Kenny L.C., Lavender T., McNamee R.. O’Neill S.M., Mills T., Khashan A.S. Advanced maternal age and adverse pregnancy outcome: evidence from a large contemporary cohort. PLoS One. 2013;8:e56583. 35. Khalil A., Syngelaki A., Maiz N., Zinevich Y., Maternal age and adverse pregnancy outcome: a cohort study. Ultrasound Obstet Gynecol. 2013; 42:634–43. 36. Laopaiboon M., Lumbiganon P., Intarut N., Mori R., Ganchimeg T., Vogel J.P., et al. Advanced maternal age and pregnancy outcomes: a multicountry assessment. BJOG. 2014;121 (Suppl 1):49–56 37. Loghi M., Crialesi R. La salute riproduttiva della donna. Roma: Istituto Nazionale di Statistica. 2017. 115p. 38. Londero A.P., Bertozzi S., Fruscalzo A., Driul L., Marchesoni D. Ultrasonographic assessment of cervix size and its correlation with female characteristics, pregnancy, bmi, and other anthropometric features. Arch Gynecol Obstet. 2011; 283:545-50. 39. Londero A.P., Rossetti E, Pittini C., Cagnacci A., Driul L. Maternal age and the risk of adverse pregnancy outcomes: a retrospective cohort study. BMC Pregnancy and Childbirth. 2019; 19:261 https://doi.org/10.1186/s12884-019-2400-x 40. Magee L.A., Ornstein M.P., von Dadelszen P. Fortnightly review: management of hypertension in pregnancy. BMJ. 1999; 318 (7194):1332-6 41. Malabarey O.T., Balayla J., Klam S.L., Shrim A., Abenhaim H.A. Pregnancies in young adolescent mothers: a population-based study on 37 million births. J Pediatr Adolesc Gynecol. 2012;25:98–102 42. .Mulla Z. D., Nuwayhid B. S., Garcia K. M. et al. Risk factors for a prolonged length of stay in women hospitalized for preeclampsia in Texas. Hypertens Pregnancy. 2010; 29 (1): 54–68. 43. Muntner P., Bowling C.B., Shimbo D. Systolic blood pressure goals to reduce cardiovascular disease among older adults. Am J Med Sci. 2014;348 (2):129-34 44. Poon LC, Shennan A, Hyett JA, et al. The International Federation of Gynecology and Obstetrics (FIGO) initiative on pre-eclampsia: a pragmatic guide for first-trimester screening and prevention. Int J Gynaecol Obstet. 2019; 145 (suppl 1): 1–33. 45. Ramakrishnan A, Lee L.J., Mitchell L.E., Agopian A.J. Maternal hypertension during pregnancy and the risk of congenital heart defects in offspring: a systematic review and meta-analysis. Pediatr Cardiol. 2015;36 (7):1442-51 46. Shan D., Qiu P.Y., Wu Y.X., Chen Q., Li A.L., Ramadoss S., et al. Pregnancy outcomes in women of advanced maternal age: a retrospective cohort study from China. Sci Rep. 2018; 8:12239 47. Sibai B.M. Chronic hypertension in pregnancy. Obstet Gynecol. 2002; 100 (2):369-77. 48. Sibai BM. Treatment of hypertension in pregnant women. N Engl J Med. 1996; 335 (4):257-65 49. Sibai B.M., Caritas S.N., Hauth J.C., MacPherson C., VanDorsten J.P., Klebanoff M., et al. Preterm delivery in women with pregestational diabetes mellitus or chronic hypertension relative to women with uncomplicated pregnancies. The National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Am J Obstet Gynecol. 2000; 183 (6):1520-4. 50. Sobotka T. Post-transitional fertility: childbearing postponement and the shift to low and unstable fertility levels. Vienna: Vienna Institute of Demography Working Papers 01. 2017. 51. Wang Y., Tanbo T., Abyholm T., Henriksen T. The impact of advanced maternal age and parity on obstetric and perinatal outcomes in singleton gestations. Arch Gynecol Obstet. 2011; 284:31–7. 52. Waters E.G., Wager H.P. Pregnancy and labour experiences of elderly primigravidas. J Mich State Med Soc. 1950; 49:435–9. 53. Winer N., Tsasaris V. État des connaissances: prise en charge thérapeutique de la pré-éclampsie. J Gynecol Obstet Biol Reprod. 2008; 37 (1): 5-15
Көрген адамдардың саны: 289

Түйенді сөздер:

Библиографиялық сілтемелер

Нургазина А.С., Сләмханова Н.С., Шалгумбаева Г.М. Шығыс Қазақстан облысы, Семей қаласындағы жүктілерде преэклампсияның пайда болу факторларын анықтау // Ғылым және Денсаулық сақтау. 2020. 2 (Т.22). Б. 109-117. doi 10.34689/SH.2020.22.2.013

Авторизируйтесь для отправки комментариев