بررسي ارتباط بين اندازه دور كمر، در پيشگويي ابتلا به فشار خون بارداري

Assessment of the Relation of Waist Circumference in Predicting Hypertension in Pregnancy

ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﻓﺸﺎﺭ ﺧﻮﻥ ﺑﺎﻻ ﻳﮑﻲ ﺍﺯ ﻋﻮﺍﺭﺽ ﺧﻄﺮﻧﺎﮎ ﺩﻭﺭﺍﻥ ﺑﺎﺭﺩﺍﺭﻱ ﺍﺳﺖ. ﻣﻄﺎﻟﻌﺎﺕ ﺍﺯ ﻧﻘﺶ ﺭﺳﻮﺏ ﻣﺮﮐﺰﻱ ﭼﺮﺑﻲ ﺑﻌﻨﻮﺍﻥ ﻋﺎﻣﻞ ﺍﻓﺰﺍﻳﺶ ﻓﺸﺎﺭ ﺧﻮﻥ، ﻣﻘﺎﻭﻣﺖ ﺑﻪ ﺍﻧﺴﻮﻟﻴﻦ ﻭ ﺍﻓﺰﺍﻳﺶ ﺳﻄﺢ ﭼﺮﺑﻲ ﻫﺎﻱ ﭘﻼﺳﻤﺎ ﺣﻤﺎﻳﺖ ﻣﻲ ﮐﻨﻨﺪ. ﺍﻧﺪﺍﺯﻩ ﺩﻭﺭ ﮐﻤﺮ ﻳﮏ ﻭﺳﻴﻠﻪ ﺑﺮﺍﻱ ﺑﺮﺭﺳﯽ ﻣﻴﺰﺍﻥ ﺗﺠﻤﻊ ﻭﺍﻗﻌﻲ ﭼﺮﺑﻲ ﺷﮑﻤﻲ ﻭ ﮐﻞ ﺑﺪﻥ ﺩﺭ ﺯﻧﺎﻥ ﻏﻴﺮ ﺑﺎﺭﺩﺍﺭ ﺍﺳﺖ ﻭ ﺍﺭﺗﺒﺎﻁ ﻧﺰﺩﻳﮑﻲ ﺑﺎ ﺷﺎﺧﺺ ﺗﻮﺩﻩ ﺑﺪﻧﻲ ﺩﺍﺭﺩ. ﻫﺪﻑ ﺍﺯ ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺑﺮﺭﺳﻲ ﺍﺭﺗﺒﺎﻁ ﺑﻴﻦ ﺍﻧﺪﺍﺯﻩ ﺩﻭﺭ ﮐﻤﺮ ﺩﺭ ﭘﻴﺶ ﺑﻴﻨﻲ ﺍﺑﺘﻼ ﺑﻪ ﭘﺮﻩ ﺍﮐﻼﻣﭙﺴﻲ ﻣﻲ ﺑﺎﺷﺪ. ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﻴﻔﻲ ـ ﻫﻤﺒﺴﺘﮕﻲ ﺑﻪ ﺭﻭﻱ 800 ﺯﻥ ﺑﺎﺭﺩﺍﺭ ﺗﻚ ﻗﻠﻮ ﺑﺎ ﺳﻦ ﺑﺎﺭﺩﺍﺭﻱ ﻛﻤﺘﺮ ﺍﺯ 16 ﻫﻔﺘﻪ ﺍﻧﺠﺎﻡ ﺷﺪ. ﺍﻧﺪﺍﺯﻩ ﺩﻭﺭ ﮐﻤﺮ، ﻓﺸﺎﺭ ﺧﻮﻥ، ﺳﻦ ﻣﺎﺩﺭ، ﺳﻦ ﺣﺎﻣﻠﮕﻲ ﺑﺮﺍﺳﺎﺱ ﺳﻮﻧﻮﮔﺮﺍﻓﻲ ﺩﺭ ﺍﻭﻟﻴﻦ ﻣﺮﺍﺟﻌﻪ ﺛﺒﺖ ﮔﺮﺩﻳﺪ. ﺳﭙﺲ ﺍﻳﻦ ﺍﻓﺮﺍﺩ ﺗﺎ ﭘﺎﻳﺎﻥ ﺩﻭﺭﺍﻥ ﺑﺎﺭﺩﺍﺭﻱ ﺍﺯﻧﻈﺮ ﺍﺑﺘﻼ ﺑﻪ ﭘﺮﻓﺸﺎﺭﻱ ﺧﻮﻥ ﺑﺎﺭﺩﺍﺭﻱ، ﺩﺭ ﻓﻮﺍﺻﻞ ﺳﻪ ﻣﺎﻫﻪ ﭘﺎﻳﺶ ﮔﺮﺩﻳﺪﻧﺪ. ﺩﺭ ﻧﻬﺎﻳﺖ ﺩﺍﺩﻩ ﻫﺎ ﺩﺭ ﻧﺮﻡ ﺍﻓﺰﺍﺭ SPSS ﻭ ﺑﺎ ﺁﺯﻣﻮﻥ ﻫﺎﻱ ﺁﻣﺎﺭﻱ ﺗﻮﺻﻴﻔﻲ ﻭ ﺍﺳﺘﻨﺒﺎﻃﻲ ﻣﻮﺭﺩ ﺗﺠﺰﻳﻪ ﻭ ﺗﺤﻠﻴﻞ ﻗﺮﺍﺭ ﮔﺮﻓﺖ. ﻳﺎﻓﺘﻪ ﻫﺎ: 25 ﻣـﻮﺭﺩ ﻓـﺸﺎﺭ ﺧﻮﻥ ﺑﺎﺭﺩﺍﺭﻱ ﺛﺒﺖ ﮔﺮﺩﻳﺪ. ﻫﻴﭻ ﺍﺭﺗﺒﺎﻁ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﻣﻴﺎﻥ ﺩﻭﺭ ﻛﻤﺮ ﺑﻴﻦ ﻫﻔﺘﻪ 6 ﺗﺎ 16 ﻭ ﺳﻦ ﺣﺎﻣﻠﮕﻲ ﺑﻪ ﻫﻔـﺘﻪ ﻭﺟـﻮﺩ ﻧﺪﺍﺷﺖ. ﻫﻤﺒﺴﺘـﮕﻲ ﻣﻌﻨﻲ ﺩﺍﺭﻱ ﺑﻴﻦ ﺩﻭﺭ ﺍﻧﺪﺍﺯﻩ ﻛﻤﺮ ﻭ ﺷﺎﺧﺺ ﺗﻮﺩﻩ ﺑﺪﻧﻲ ﺩﺭ ﺯﻣﺎﻥ ﭘﺬﻳﺮﺵ ﻭﺟـﻮﺩ ﺩﺍﺷﺖ )0/001

Introduction & Objective: Hypertension is dangerous and relatively frequent risk factors in gestational periods. Studies have shown that central lipid precipitation is a cause of hypertension, insulin resistance and increased in plasma lipids. Waist circumference is a way for evaluating of lipid in abdomen and whole body in non-pregnant women and it has a close relationship with Body Mass Index (BMI). The aim of this study is the evaluation of relationship between waist circumference and preeclampsia and its diagnostic value in predicting preeclampsia. Materials & Methods: This was a cohort and prospective study on 800 pregnant women with singleton fetus and gestational age less than 16 weeks. Waist circumference, blood pressure, maternal age, gestational age on the basis of sonographic result and previous hypertension were recorded in first visit. Then these women were evaluated every three month for hypertension, until their delivery. Finally, the data were analyzed by SPSS software and descriptive and deductive tests. Results: 25 cases (2.7%) of pregnancy related hypertension were recorded. There was no significant relationship between waist circumference and gestational age in 6-16 weeks of pregnancy, but there was a meaningful relationship between BMI and waist circumference at the time of admission. BMI and waist circumference were cleary higher in women with pregnancy related hypertension. Conclusions: Our study shows that waist circumference can be used as a facility means of predicting the risk of preeclampsia and pregnancy related hypertension. Informing women to decrease their weight before pregnancy has special importance.