
目的 采用双样本孟德尔随机化(Mendelian randomization, MR)分析明确贫血与妊娠期高血压之间的因果关系。 方法 贫血的汇总数据来自FinnGen联盟(15 153例和393 684例对照)。妊娠期高血压的汇总数据来自FinnGen联盟(16 417例和213 893例对照)。本孟德尔随机化分析采用逆方差加权(inverse⁃variance weighted, IVW)分析、加权中位数(weighted⁃median, WM)分析、MR⁃Egger回归进行了灵敏度分析以确认结果的准确性和稳定性。 结果 通过IVW分析发现,遗传预测的贫血与妊娠期高血压疾病呈显著正相关。通过IVW分析发现,贫血对妊娠期高血压有显著影响(OR = 1.313,95% CI:1.179 ~ 1.461; P < 0.001)和WM(OR = 1.287,95% CI:1.120 ~ 1.480; P < 0.001)。 结论 贫血与妊娠期高血压风险之间的因果关系得到了遗传预测的确定。未来应该加强贫血人群预防妊娠期高血压的意识。
","endNoteUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=EndNote&id=754","reference":"1 | 李玉明, 杨宁. 《妊娠期高血压疾病血压管理专家共识(2019)》解读[J]. 中华高血压杂志, 2020, 28(8): 714. |
2 | 蒲丛珊, 樊雪梅, 夏家爱, 等. 妊娠期高血压疾病孕妇患病体验质性研究的Meta整合[J]. 中华护理杂志, 2022, 57(21): 2644. |
3 | Cakir SC, Dorum BA, Koksal N, et al. The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants[J]. Pak J Med Sci, 2020, 36(2): 26. |
4 | 刘敏. 妊娠期高血压疾病的管理策略探讨[J]. 实用妇科内分泌电子杂志, 2023, 10(34): 48. |
5 | Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy[J]. Eur Heart J, 2018, 39(34): 3165. |
6 | 马翠, 伍绍文, 张为远. 不同类型妊娠期高血压疾病母婴结局临床分析[J]. 中国医刊, 2018, 53(4): 415. |
7 | 周博鑫, 吴淑贞, 李杨, 等. 胰岛素抵抗对妊娠期高血压疾病及妊娠结局的影响[J]. 中国医刊, 2019, 54(7): 777. |
8 | Lu CQ, Lin J, Yuan L, et al. Pregnancy induced hypertension and outcomes in early and moderate preterm infants[J]. Pregnancy Hypertens, 2018, 14: 68. |
9 | Hao H, Gu X, Cai Y, et al. The influence of pregnancy-induced hypertension syndrome on the metabolism of newborns[J]. Transl Pediatr, 2021, 10(2): 296. |
10 | 刘艳会, 梁琨. 妊娠期高血压疾病对胎龄28~34周早产儿外周静脉血细胞计数的影响[J]. 中国当代儿科杂志, 2022, 24(1): 60. |
11 | Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries[J]. Ann N Y Acad Sci, 2019, 1450(1): 15. |
12 | 刘思华, 高云飞, 满露, 等. 妊娠期贫血对分娩结局的影响探讨[J]. 实用妇科内分泌电子杂志, 2023, 10(32): 43. |
13 | 王广燕, 刘璐, 王巧黎, 等. 多糖铁对比硫酸亚铁用于妊娠期贫血安全性的Meta分析[J]. 中国药房, 2023, 34(13): 1627. |
14 | Rogozińska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis[J]. Lancet Haematol, 2021, 8(7): e503. |
15 | Lin L, Wei YM, Zhu WW, et al. Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study[J]. BMC Pregnancy Childbirth, 2018, 18(1): 111. |
16 | Karami M, Chaleshgar M, Salari N, et al. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis[J]. Matern Child Health J, 2022, 26(7): 1473. |
17 | Zhang PP, Zhong XW. Analysis of risk factors and construction of nomograph model for critical condition of patients with hypertension during pregnancy[J]. BMC Pregnancy Childbirth, 2023, 23(1): 576. |
18 | Yemane A, Teka H, Ahmed S, et al. Gestational hypertension and progression towards preeclampsia in northern Ethiopia: prospective cohort study[J]. BMC Pregnancy Childbirth, 2021, 21(1): 261. |
19 | Hemani G, Zheng J, Elsworth B, et al. The MR-base platform supports systematic causal inference across the human phenome[J]. Elife, 2018, 7: e34408. |
20 | 杨玉洁, 钟溢源, 郑旭威, 等. 血清代谢物与银屑病的风险——一项两样本孟德尔随机化研究[J]. 中国皮肤性病学杂志, 2024, 38(6): 620. |
21 | Emdin CA, Khera AV, Kathiresan S. Mendelian randomization[J]. JAMA, 2017, 318(19): 1925. |
22 | Hartwig FP, Borges MC, Horta BL, et al. Inflammatory biomarkers and risk of schizophrenia: a2-sample mendelian randomization study[J]. JAMA Psychiatry, 2017, 74(12): 1226. |
23 | von Elm E, Altman DG, Egger M, et al. Strengthening the reporting of observational studies in epidemiology (STROBE) statement:guidelines for reporting observational studies[J]. BMJ, 2007, 335(7624): 806. |
24 | Papadimitriou N, Dimou N, Tsilidis KK, et al. Physical activity and risks of breast and colorectal cancer: a mendelian randomisation analysis[J]. Nat Commun, 2020, 11(1): 597. |
25 | Burgess S, Dudbridge F, Thompson SG. Combining information on multiple instrumental variables in mendelian randomization: comparison of allele score and summarized data methods[J]. Stat Med, 2016, 35(11): 1880. |
26 | Pagoni P, Korologou-Linden RS, Howe LD, et al. Causal effects of circulating cytokine concentrations on risk of Alzheimer's disease and cognitive function[J]. Brain Behav Immun, 2022, 104: 54. |
27 | Bowden J, Del Greco M F, Minelli C, et al. A framework for the investigation of pleiotropy in two-sample summary data mendelian randomization[J]. Stat Med, 2017, 36(11): 1783. |
28 | Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-egger method[J]. Eur J Epidemiol, 2017, 32(5): 377. |
29 | Verbanck M, Chen CY, Neale B, et al. Detection of widespread horizontal pleiotropy in causal relationships inferred from mendelian randomization between complex traits and diseases[J]. Nat Genet, 2018, 50(5): 693. |
30 | Broadbent JR, Foley CN, Grant AJ, et al. MendelianRandomization v0.5.0: updates to an R package for performing mendelian randomization analyses using summarized data[J]. Wellcome Open Res, 2020, 5: 252. |
31 | Maher GM, Mccarthy FP, Mccarthy CM, et al. A perspective on pre-eclampsia and neurodevelopmental outcomes in the offspring: does maternal inflammation play a role?[J]. Int J Dev Neurosci, 2019, 77: 69. |
32 | 李发红, 韩娜, 江楠, 等. 高龄妊娠期高血压疾病产妇胎盘Klotho表达与妊娠结局[J]. 中国计划生育学杂志, 2019, 27(10): 1304. |
33 | 宋伟, 李光辉. 与肥胖相关的短链脂肪酸水平失衡对妊娠期高血压疾病影响的研究进展[J]. 医学综述, 2021, 27(24): 4805. |
34 | 葛君. 妊娠期贫血发病的高危因素及其对妊娠结局及HCT、Hb水平影响评价[J]. 临床医药文献电子杂志, 2019, 6(52): 79. |
35 | 赵思宇, 景文展, 刘珏, 等. 中国妇女2012—2016年妊娠期贫血患病状况的Meta分析[J]. 中华预防医学杂志, 2018, 52(9): 951. |
Objective The causal relationship between Anaemias and hypertension in pregnancy remains unclear. Thise article is to examine the causal association between Anaemias and hypertension in pregnancy with two-sample Mendelian randomization analyses. Methods Summary-level data for anaemias are obtained from the FinnGen consortium (15 153 cases and 393 684 controls). Summary-level data for hypertension in pregnancy are obtained from the FinnGen consortium (16 417 cases and 213 893 controls). Inverse-variance weighted analysis, weighted-median analysis, and Mendelian randomization-Egger regression are conducted in this Mendelian randomization analysis. Sensitivity analyses are conducted to confirm the accuracy and robustness of the results. Results Using IVW, it is found that genetically predicted Anaemias is significantly positively associated with hypertension disorders in pregnancy. Genetically determined childhood obesity significantly affects hypertension in pregnancy by IVW (OR = 1.313,95% CI:1.179 - 1.461;P < 0.001) and weighted median (OR = 1.287,95% CI: 1.120 - 1.480;P < 0.001). Conclusion A causal effect between genetically predicted Anaemias and the risk of hypertension in pregnancy has been identified. The prevention of hypertension in pregnancy should be promoted in populations with Anaemias.
","bibtexUrl_en":"http://xuebao.sdfmu.edu.cn/EN/article/getTxtFile.do?fileType=BibTeX&id=754","abstractUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/10.3969/j.issn.2097-0005.2025.02.001","zuoZheCn_L":"王纯, 刘涛, 李磊","juanUrl_cn":"http://xuebao.sdfmu.edu.cn/CN/Y2025","lanMu_en":"Basic Researches","qiUrl_en":"//www.pitakata.com/xuebao/EN/Y2025/V46/I2","zuoZhe_EN":"Chun WANG1,2,3, Tao LIU3, Lei LI4,5(A Mendelian randomization study of anemia and hypertension in pregnancy
Chun WANG, Tao LIU, Lei LI
Journal of ShanDong First Medical University&ShanDong Academy of Medical Sciences››2025, Vol. 46››Issue (2): 65-71.
A Mendelian randomization study of anemia and hypertension in pregnancy
ObjectiveThe causal relationship between Anaemias and hypertension in pregnancy remains unclear. Thise article is to examine the causal association between Anaemias and hypertension in pregnancy with two-sample Mendelian randomization analyses.MethodsSummary-level data for anaemias are obtained from the FinnGen consortium (15 153 cases and 393 684 controls). Summary-level data for hypertension in pregnancy are obtained from the FinnGen consortium (16 417 cases and 213 893 controls). Inverse-variance weighted analysis, weighted-median analysis, and Mendelian randomization-Egger regression are conducted in this Mendelian randomization analysis. Sensitivity analyses are conducted to confirm the accuracy and robustness of the results.ResultsUsing IVW, it is found that genetically predicted Anaemias is significantly positively associated with hypertension disorders in pregnancy. Genetically determined childhood obesity significantly affects hypertension in pregnancy by IVW (OR= 1.313,95%CI:1.179 - 1.461;P< 0.001) and weighted median (OR= 1.287,95%CI: 1.120 - 1.480;P< 0.001).ConclusionA causal effect between genetically predicted Anaemias and the risk of hypertension in pregnancy has been identified. The prevention of hypertension in pregnancy should be promoted in populations with Anaemias.
anaemias/hypertension in pregnancy/mendelian randomization/genome-wide association study/cause and effect inference
1 | 李玉明, 杨宁. 《妊娠期高血压疾病血压管理专家共识(2019)》解读[J].中华高血压杂志,2020,28(8): 714. |
2 | 蒲丛珊, 樊雪梅, 夏家爱, 等. 妊娠期高血压疾病孕妇患病体验质性研究的Meta整合[J].中华护理杂志,2022,57(21): 2644. |
3 | Cakir SC, Dorum BA, Koksal N, et al. The effects of maternal preeclampsia on inflammatory cytokines and clinical outcomes in premature infants[J].Pak J Med Sci,2020,36(2): 26. |
4 | 刘敏. 妊娠期高血压疾病的管理策略探讨[J].实用妇科内分泌电子杂志,2023,10(34): 48. |
5 | Regitz-Zagrosek V, Roos-Hesselink JW, Bauersachs J, et al. 2018 ESC guidelines for the management of cardiovascular diseases during pregnancy[J].Eur Heart J,2018,39(34): 3165. |
6 | 马翠, 伍绍文, 张为远. 不同类型妊娠期高血压疾病母婴结局临床分析[J].中国医刊,2018,53(4): 415. |
7 | 周博鑫, 吴淑贞, 李杨, 等. 胰岛素抵抗对妊娠期高血压疾病及妊娠结局的影响[J].中国医刊,2019,54(7): 777. |
8 | Lu CQ, Lin J, Yuan L, et al. Pregnancy induced hypertension and outcomes in early and moderate preterm infants[J].Pregnancy Hypertens,2018,14: 68. |
9 | Hao H, Gu X, Cai Y, et al. The influence of pregnancy-induced hypertension syndrome on the metabolism of newborns[J].Transl Pediatr,2021,10(2): 296. |
10 | 刘艳会, 梁琨. 妊娠期高血压疾病对胎龄28~34周早产儿外周静脉血细胞计数的影响[J].中国当代儿科杂志,2022,24(1): 60. |
11 | Chaparro CM, Suchdev PS. Anemia epidemiology, pathophysiology, and etiology in low- and middle-income countries[J].Ann N Y Acad Sci,2019,1450(1): 15. |
12 | 刘思华, 高云飞, 满露, 等. 妊娠期贫血对分娩结局的影响探讨[J].实用妇科内分泌电子杂志,2023,10(32): 43. |
13 | 王广燕, 刘璐, 王巧黎, 等. 多糖铁对比硫酸亚铁用于妊娠期贫血安全性的Meta分析[J].中国药房,2023,34(13): 1627. |
14 | Rogozińska E, Daru J, Nicolaides M, et al. Iron preparations for women of reproductive age with iron deficiency anaemia in pregnancy (FRIDA): a systematic review and network meta-analysis[J].Lancet Haematol,2021,8(7): e503. |
15 | Lin L, Wei YM, Zhu WW, et al. Prevalence, risk factors and associated adverse pregnancy outcomes of anaemia in Chinese pregnant women: a multicentre retrospective study[J].BMC Pregnancy Childbirth,2018,18(1): 111. |
16 | Karami M, Chaleshgar M, Salari N, et al. Global prevalence of anemia in pregnant women: a comprehensive systematic review and meta-analysis[J].Matern Child Health J,2022,26(7): 1473. |
17 | Zhang PP, Zhong XW. Analysis of risk factors and construction of nomograph model for critical condition of patients with hypertension during pregnancy[J].BMC Pregnancy Childbirth,2023,23(1): 576. |
18 | Yemane A, Teka H, Ahmed S, et al. Gestational hypertension and progression towards preeclampsia in northern Ethiopia: prospective cohort study[J].BMC Pregnancy Childbirth,2021,21(1): 261. |
19 | Hemani G, Zheng J, Elsworth B, et al. The MR-base platform supports systematic causal inference across the human phenome[J].Elife,2018,7: e34408. |
20 | 杨玉洁, 钟溢源, 郑旭威, 等. 血清代谢物与银屑病的风险——一项两样本孟德尔随机化研究[J].中国皮肤性病学杂志,2024,38(6): 620. |
21 | Emdin CA, Khera AV, Kathiresan S. Mendelian randomization[J].JAMA,2017,318(19): 1925. |
22 | Hartwig FP, Borges MC, Horta BL, et al. Inflammatory biomarkers and risk of schizophrenia: a2-sample mendelian randomization study[J].JAMA Psychiatry,2017,74(12): 1226. |
23 | von Elm E, Altman DG, Egger M, et al. Strengthening the reporting of observational studies in epidemiology (STROBE) statement:guidelines for reporting observational studies[J].BMJ,2007,335(7624): 806. |
24 | Papadimitriou N, Dimou N, Tsilidis KK, et al. Physical activity and risks of breast and colorectal cancer: a mendelian randomisation analysis[J].Nat Commun,2020,11(1): 597. |
25 | Burgess S, Dudbridge F, Thompson SG. Combining information on multiple instrumental variables in mendelian randomization: comparison of allele score and summarized data methods[J].Stat Med,2016,35(11): 1880. |
26 | Pagoni P, Korologou-Linden RS, Howe LD, et al. Causal effects of circulating cytokine concentrations on risk of Alzheimer's disease and cognitive function[J].Brain Behav Immun,2022,104: 54. |
27 | Bowden J, Del Greco M F, Minelli C, et al. A framework for the investigation of pleiotropy in two-sample summary data mendelian randomization[J].Stat Med,2017,36(11): 1783. |
28 | Burgess S, Thompson SG. Interpreting findings from Mendelian randomization using the MR-egger method[J].Eur J Epidemiol,2017,32(5): 377. |
29 | Verbanck M, Chen CY, Neale B, et al. Detection of widespread horizontal pleiotropy in causal relationships inferred from mendelian randomization between complex traits and diseases[J].Nat Genet,2018,50(5): 693. |
30 | Broadbent JR, Foley CN, Grant AJ, et al. MendelianRandomization v0.5.0: updates to an R package for performing mendelian randomization analyses using summarized data[J].Wellcome Open Res,2020,5: 252. |
31 | Maher GM, Mccarthy FP, Mccarthy CM, et al. A perspective on pre-eclampsia and neurodevelopmental outcomes in the offspring: does maternal inflammation play a role?[J].Int J Dev Neurosci,2019,77: 69. |
32 | 李发红, 韩娜, 江楠, 等. 高龄妊娠期高血压疾病产妇胎盘Klotho表达与妊娠结局[J].中国计划生育学杂志,2019,27(10): 1304. |
33 | 宋伟, 李光辉. 与肥胖相关的短链脂肪酸水平失衡对妊娠期高血压疾病影响的研究进展[J].医学综述,2021,27(24): 4805. |
34 | 葛君. 妊娠期贫血发病的高危因素及其对妊娠结局及HCT、Hb水平影响评价[J].临床医药文献电子杂志,2019,6(52): 79. |
35 | 赵思宇, 景文展, 刘珏, 等. 中国妇女2012—2016年妊娠期贫血患病状况的Meta分析[J].中华预防医学杂志,2018,52(9): 951. |
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