We examined the impact of chronic hypertension (HTN), gestational HTN, and preeclampsia on placental maternal and fetal vascular circulation. Of the 1047 women who gave birth and underwent a placental histopathologic examination between 2007 and 2013 at Wolfson Medical Center, 140 women were included in the present study: 34 women with preeclampsia, 25 women with chronic HTN, 28 women with gestational HTN, and 53 women without hypertensive disorder, matched by age, gravidity, parity, and mode of delivery.Placental lesions related to maternal vascular malperfusion (MVM) differed significantly across groups (P < .0001) and were highest in subjects with chronic HTN and preeclampsia (72% and 65%, respectively) and lowest in women without hypertensive disorder (26%). Placental fetal vascular malperfusion rate did not differ significantly between groups (P = .767). In the logistic regression analysis, chronic HTN emerged as a significant predictor of placental MVM and increased the risk of this outcome more than sixfold (odds ratio 6.614, 95% confidence interval 2.047-21.37, P = .002). Preeclampsia emerged as a significant predictor of MVM and more than tripled the risk of this outcome (odds ratio 3.468, 95% confidence interval 1.083-11.103, P = .036). Gestational HTN was not significantly associated with increased MVM rate. We demonstrated that chronic HTN and preeclampsia were associated with an increased rate of vascular placental maternal malperfusion and emerged as significant independent predictors of this outcome.

中文翻译：

---

妊娠高血压疾病与胎盘母体和胎儿血管循环的关系。

我们检查了慢性高血压（HTN），妊娠性HTN和先兆子痫对胎盘母体和胎儿血管循环的影响。在2007年至2013年之间在沃尔夫森医学中心分娩并进行了胎盘组织病理检查的1047名妇女中，本研究包括140名妇女：先兆子痫妇女34例，慢性HTN妇女25例，妊娠HTN妇女28例，以及53例没有高血压疾病的女性，其年龄，妊娠率，胎次和分娩方式相匹配。与母体血管灌注不足（MVM）有关的胎盘病变在各组之间差异显着（P <.0001），在患有慢性HTN和先兆子痫的受试者中最高（72分别为50％和65％），在没有高血压疾病的女性中最低（26％）。两组胎盘胎儿血管灌注不良率无显着差异（P = .767）。在逻辑回归分析中，慢性HTN成为胎盘MVM的重要预测指标，其结局风险增加了六倍以上（优势比6.614，95％置信区间2.047-21.37，P = .002）。子痫前期可作为MVM的重要预测指标，其风险的三倍以上（优势比3.468，95％置信区间1.083-11.103，P = .036）。妊娠期HTN与MVM率升高无显着相关性。我们证明了慢性HTN和先兆子痫与血管性胎盘母体灌注异常的发生率增加有关，并成为这一结果的重要独立预测因子。慢性HTN成为胎盘MVM的重要预测指标，并且使这一结局的风险增加了六倍以上（优势比6.614，95％置信区间2.047-21.37，P = 0.002）。子痫前期可作为MVM的重要预测指标，其风险的三倍以上（优势比3.468，95％置信区间1.083-11.103，P = .036）。妊娠期HTN与MVM率升高无显着相关性。我们证明了慢性HTN和先兆子痫与血管性胎盘母体灌注异常的发生率增加有关，并成为这一结果的重要独立预测因子。慢性HTN成为胎盘MVM的重要预测指标，并且使这一结局的风险增加了六倍以上（优势比6.614，95％置信区间2.047-21.37，P = .002）。子痫前期可作为MVM的重要预测指标，其风险的三倍以上（优势比3.468，95％置信区间1.083-11.103，P = .036）。妊娠期HTN与MVM率升高无显着相关性。我们证明了慢性HTN和先兆子痫与血管性胎盘母体灌注异常的发生率增加有关，并成为这一结果的重要独立预测因子。子痫前期可作为MVM的重要预测指标，其风险的三倍以上（优势比3.468，95％置信区间1.083-11.103，P = .036）。妊娠期HTN与MVM率升高无显着相关性。我们证明了慢性HTN和先兆子痫与血管性胎盘母体灌注异常的发生率增加有关，并成为这一结果的重要独立预测因子。子痫前期可作为MVM的重要预测指标，其风险的三倍还多（优势比3.468，95％置信区间1.083-11.103，P = .036）。妊娠期HTN与MVM率升高无显着相关性。我们证明了慢性HTN和先兆子痫与血管性胎盘母体灌注异常的发生率增加有关，并成为这一结果的重要独立预测因子。