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  • 俞晓敏,古航.高龄孕妇妊娠合并症和并发症临床分析[J].第二军医大学学报,2018,39(2):159-164    [点击复制]
  • YU Xiao-min,GU Hang.Clinical analysis on pregnancy complications of senile pregnant women[J].Acad J Sec Mil Med Univ,2018,39(2):159-164   [点击复制]
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高龄孕妇妊娠合并症和并发症临床分析
俞晓敏,古航*
0
(第二军医大学长海医院妇产科, 上海 200433
*通信作者)
摘要:
目的 研究高龄孕妇妊娠期合并症和并发症的发生情况与其分娩方式和妊娠结局。方法 收集2010年1月至2016年12月第二军医大学长海医院产科住院分娩的10 508例孕产妇的病历资料,根据分娩年龄分为高龄组(≥ 35岁,1 130例)和非高龄组(<35岁,9 378例)。应用χ2检验比较2组妊娠期合并症和并发症的发生率、剖宫产率、剖宫产指征构成比、孕产妇与围生儿的结局。结果 2010年至2016年高龄孕妇的比例呈持续上升趋势,由2010年的6.75%(89/1 319)上升至2016年的15.82%(267/1 688)。高龄组剖宫产率为67.08%(758/1 130),剖宫产指征中社会因素的比例为42.88%(325/758),均高于非高龄组[48.51%(4 549/9 378)、10.07%(458/4 549),P均<0.01]。高龄组妊娠期糖尿病、胎膜早破、前置胎盘、胎盘植入异常和产后出血的发生率均高于非高龄组(P均<0.05)。高龄组孕妇妊娠期高血压、子痫前期、慢性高血压合并妊娠的发病率均高于非高龄组(P均<0.05)。高龄组妊娠期合并肝脏疾病、泌尿系统疾病、甲状腺功能异常、血栓性疾病和恶性肿瘤的发生率均高于非高龄组(P均<0.05)。围生儿结局中,高龄组新生儿窒息、围生儿死亡和早产儿的发生率均高于非高龄组(P均<0.05)。结论 高龄孕妇妊娠期合并症和并发症、不良妊娠结局发生风险升高,应提倡适龄妊娠并加强高龄妊娠围产期监护。
关键词:  高龄孕妇  妊娠合并症  剖宫产指征  妊娠结局
DOI:10.16781/j.0258-879x.2018.02.0159
投稿时间:2017-08-31修订日期:2017-10-17
基金项目:
Clinical analysis on pregnancy complications of senile pregnant women
YU Xiao-min,GU Hang*
(Department of Obstetrics and Gynecology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author)
Abstract:
Objective To study the pregnancy complication incidences, delivery manners and pregnancy outcomes of senile pregnant women. Methods The medical records of 10 508 cases of pregnant and delivery women, who were hospitalized for delivery in Obstetrical Department of Changhai Hospital of Second Military Medical University from Jan. 2010 to Dec. 2016, were collected and analyzed. According to delivery age, they were divided into the senile group (≥ 35 years old, n=1 130) and the non-senile group (<35 years old, n=9 378). Chi-square test was used to compare the incidences of pregnancy complications, cesarean section rate, ratio of cesarean section indications and outcomes of maternal and perinatal infants between the two groups. Results The proportion of senile pregnant women increased from 6.75% (89/1 319) in 2010 to 15.82% (267/1 688) in 2016. The cesarean section rate and the ratio of social factors in the senile group were higher than those in the non-senile group (67.08%[758/1 130] vs 48.51%[4 549/9 378], 42.88%[325/758] vs 10.07%[458/4 549], both P<0.01). The incidences of gestational diabetes mellitus, premature rupture of membrane, placenta praevia, placental implantation abnormality and postpartum hemorrhage of the senile group were significantly higher than those of the non-senile group (all P<0.05). The incidences of pregnancy-induced hypertension syndrome, pre-eclampsia, chronic hypertension complicating pregnancy of the senile group were significantly higher than those of the non-senile group (all P<0.05). The incidences of liver diseases, diseases of urinary system, abnormal thyroid function, thrombotic diseases and malignant tumor complicated with pregnancy were significantly higher in the senile group than those in the non-senile group (all P<0.05). For outcome of perinatal infants, the onset rates of asphyxia neonatorum, death of perinatal infants and premature infants were significantly higher in the senile group than those in the non-senile group (all P<0.05). Conclusion The risks of pregnancy complications and adverse pregnancy outcomes are increased in senile pregnant women. Appropriate-age pregnancy and perinatal care of senile pregnancy should be advocated in clinic.
Key words:  elderly gravida  pregnancy complication  cesarean section indication  pregnancy outcome