实用医学杂志 ›› 2022, Vol. 38 ›› Issue (7): 884-888.doi: 10.3969/j.issn.1006⁃5725.2022.07.020

• 临床研究 • 上一篇    下一篇

高龄孕产妇的妊娠结局与孕检的关系

李江恒 钟柳育 马聆桦 黄永全 朱茂灵   

  1. 南宁市妇幼保健院妇幼健康和计划生育服务部(南宁 530022)

  • 出版日期:2022-04-10 发布日期:2022-04-10
  • 通讯作者: 朱茂灵 E⁃mail:3152284326@qq.com

Relationship of pregnancy outcomeswith pregnancy examination among olderparturient women 

 LI Jiangh⁃ eng,ZHONG Liuyu,MA Linghua,HUANG Yongquan,ZHU Maoling.   

  1. Department of Maternity⁃Child Health and Family Planning Services,Maternal and Child Health Hospital of Nanning,Nanning 530022,China

  • Online:2022-04-10 Published:2022-04-10
  • Contact: ZHU Maoling E⁃mail:3152284326@qq.com
  • Supported by:
    南宁市科学研究与技术开发计划项目(编号:20183038⁃3)

摘要:

目的 探讨高龄孕产妇的临床特征、妊娠结局,以及孕早检、孕检次数对高龄孕产妇妊娠结 局的影响方法 收集户籍和分娩均在南宁市六城区的 108 734 例孕产妇的临床和妊娠结局资料,按照 年龄划分为适龄组(年龄 20 ~ 34 岁)和高龄组(年龄≥35 岁)。结果 高龄孕产妇孕早检和孕检次数≥5 比例显著低于适龄组,而孕次≥3次、经产、剖宫产史、人工或自然流产≥3次、辅助生殖技术受孕、多胎、孕期接 触可疑致畸物质、重度高危妊娠的比例显著高于适龄组(均P < 0.01)。高龄孕产妇分娩孕周 < 37、低出生体 质量、极低出生体质量、足月小样儿、胎儿生长受限、巨大儿、5 min Apgar < 7、剖宫产、出生缺陷、死胎的发 生率显著高于适龄组(均 P < 0.01)。多因素 logistic 回归显示,孕早检和孕检次数≥ 5 是高龄孕产妇分娩孕 < 37、低出生体质量、胎儿生长受限、5 min Apgar < 7、剖宫产、死胎等不良妊娠结局的保护因素(均P < 0.05)。 结论 高龄孕产妇容易出现不良妊娠结局,而孕期规范检查能降低高龄孕产妇不良妊娠结局发生风险。

关键词:

高龄, 孕产妇, 妊娠结局, 孕早检, 孕检次数

Abstract:

Objective To explore the clinical characteristics and pregnancy outcomes in older parturient⁃ women,and study the influence of examination at first trimester and number of prenatal visits on pregnancy out⁃ comes among them. Methods A total of 108 734 parturient women from six urban districts of Nanning with both household registration and delivery registered in Nanning were recruited and allocated to the control group(aged 20 ~ 34 years)and the older group(aged ≥ 35 years). The data of clinical characteristics and pregnancy outcomes were collected and retrospectively analyzed. Results The rate of the women who took the examination at first trimester andprenatal visits ≥ 5 times in the control group was significantly lower than that in the older group(P < 0.01). The rates of those with the history of pregnancy ≥ 3 times,multiparity orcesarean section,spontaneous or induced abortion ≥ 3 times,assisted reproductive technology,multiple pregnancy,exposure to suspected teratogenic substances,or severe high⁃risk pregnancy in the older group were significantly higher than those of the control group (all P < 0.01). The incidence rates of deliverywith < 37w gestation,lowbirth weight,extremely low birth weight full ⁃term underweight,fetal growth restriction,macrosomia,Apgar scores below 7 at 5 min,cesarean section birth defects and stillbirthin the oldergroup were significantly higher than those in the control(all P < 0.01). Bymul⁃ tivariateLogistic regression,the examination at first trimester and prenatal visits ≥ 5 times were the protective factors of adverse pregnancy outcomes of elder parturient women such as delivery with < 37 w gestation,low birth weight,fetal growth restriction,Apgar scores below 7 at 5 min,cesarean section and stillbirth(all P < 0.05). Conclusion Older parturient women are prone to adverse pregnancy outcomes,and fulfilled standard antenatal care may decrease the risk of adverse pregnancy outcomes among them.

Key words:

advanced age, parturient women, pregnancy outcomes, examination at first trimester, number of prenatal visits