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中华产科急救电子杂志 ›› 2015, Vol. 04 ›› Issue (01) : 52 -55. doi: 10.3877/cma.j.issn.2095-3259.2015.01.012

所属专题: 文献

论著

不同孕周非治疗性早产患者的高危因素及妊娠结局分析
陈云1, 罗太珍1,(), 何亚1, 钟丽云1   
  1. 1. 510150 广州医科大学附属第三医院妇产科 广州重症孕产妇救治中心
  • 收稿日期:2015-01-03 出版日期:2015-02-18
  • 通信作者: 罗太珍
  • 基金资助:
    广州市医药卫生科技一般引导项目(20141A010080)

Analysis of risk factors and pregnancy outcomes of non-therapeutic premature birth pregnant patients at different gestational ages

Yun Chen1, Taizhen Luo1,(), Ya He1, Liyun Zhong1   

  1. 1. Department of Obstetrics and Gyneclogy, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
  • Received:2015-01-03 Published:2015-02-18
  • Corresponding author: Taizhen Luo
  • About author:
    Corresponding author: Luo Taizhen, Email:
引用本文:

陈云, 罗太珍, 何亚, 钟丽云. 不同孕周非治疗性早产患者的高危因素及妊娠结局分析[J/OL]. 中华产科急救电子杂志, 2015, 04(01): 52-55.

Yun Chen, Taizhen Luo, Ya He, Liyun Zhong. Analysis of risk factors and pregnancy outcomes of non-therapeutic premature birth pregnant patients at different gestational ages[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2015, 04(01): 52-55.

目的

探讨不同孕周非治疗性早产患者的高危因素和母儿不良结局。

方法

采用回顾性研究方法对2012年1月至2014年12月就诊于广州医科大学附属第三医院224例非治疗性早产患者资料进行分析,根据不同孕周分成4组:A组:28~29+6周(38例),B组:30~31+6周(32例),C组:32~33+6周(42例),D组:34~36+6周(112例);分析4组患者的高危因素、产妇及新生儿的不良结局。

结果

224例非治疗性早产患者发生早产的高危因素分别为胎膜早破147例(65.6%)、不良孕产史128例(57.1%)、先兆早产病史115例(51.3%)、体外受精-胚胎移植术妊娠87例(38.8%)、未规律产检53例(23.7%)、双胎妊娠25例(11.2%)。4组总产程时间分别为(4.9±3.5) h,(7.6±3.8) h,(6.7±2.9) h,(6.8±2.9) h,A组与其他3组比较,Q=1.762,2.719和1.847 (P值均<0.05)。4组急产发生率分别为44.7% (17例),9.4% (3例),16.7% (7例),14.3% (16例),A组与其他3组比较,Q=21.648,8.207和9.783(P值均<0.05)。4组新生儿窒息发生率分别为31.6% (12例), 12.5% (4例),7.1% (3例),6.3% (7例),A组与其他3组比较,Q=4.591,15.345和10.834(P值均<0.05)。4组新生儿1 min Apgar评分分别为(7.7±3.2)分,(9.1±2.4)分,(9.4±1.2)分,(9.4±1.1)分,A组与其他3组比较,Q=2.528,3.281和2.562(P值均<0.05)。4组新生儿出生体重分别为(1 555.9±470.9) g,(1 659.3±342.2) g,(1 990.8±306.5) g,(2 515.0±473.4) g,各组间差异的两两比较均存在统计学意义(P<0.01)。

结论

胎膜早破是非治疗性早产发生的最常见的高危因素,要重视28~29+6周早产高危患者的管理,并应警惕这些孕妇和新生儿不良结局的发生。

Objective

To investigate the risk factors and the adverse pregnancy outcomes of non-therapeutic premature birth pregnant patients at different gestational ages.

Methods

The clinical data of 224 non-therapeutic preterm birth patients, admitted to the Third Affiliated Hospital of Guangzhou Medical University from January 2012 to December 2014, were retrospectively analyzed. Based on the gestational age, research participants were divided into 4 groups: group A: 28-29+ 6 weeks (38 cases), group B: 30-31+ 6 weeks (32 cases), group C: 32-33+ 6 weeks (42 cases) and group D: 34-36+ 6 weeks (112 cases). The clinical data included risk factors, poor outcomes of mothers and newborns.

Results

Common risk factors of the 224 patients included premature rupture of membranes (147 cases, 65.6%), adverse history of pregnancy and parity (128 cases, 57.1%), history of threatened premature labor (115 cases, 51.3%), in vitro fertilization and embryotransfer pregnancy (87 cases, 38.8%), irregular antenatal examination (53 cases, 23.7%), and twin pregnancy (25 cases, 11.2%). The total duration of labor in the 4 groups were (4.9±3.5) hours, (7.6±3.8) hours, (6.7±2.9) hours and (6.8±2.9) hours, respectively; there were significant differences between group A and the other 3 groups(Q=1.762, 2.719, 1.847, all P value<0.05). The rate of emergency labor in the 4 groups were 44.7% (17 cases), 9.4% (3 cases), 16.7% (7 cases), 14.3% (16 cases), respectively; there were significant differences between group A and the other 3 groups (Q=21.648, 8.207 and 9.783, all P value<0.05). The incidence rate of neonatal asphyxia in the 4 groups were 31.6% (12 cases), 12.5% (4 cases), 7.1% (3 cases) and 6.3% (7 cases), respectively; there were significant differences between group A and other 3 groups (Q=4.591, 15.345 and 10.834, all P value<0.05). One-minute Apgar score of the 4 groups were (7.7±3.2) score, (9.1±2.4) score, (9.4±1.2) score, (9.4±1.1) score, respectively; there were significant differences between group A and other 3 groups (Q=2.528, 3.281 and 2.562, all P value<0.05). The birth weights of the 4 groups were (1 555.9±470.9) g, (1 659.3±342.2) g, (1 990.8±306.5) g and (2 515.0±473.4) g, respectively; there were significance differences in the groups, all P value<0.05.

Conclusions

Premature rupture of membrane was the most common risk factor of non-therapeutic preterm birth. For the preterm birth patients with gestational age from 28 to 29+ 6 weeks, we should pay attention to the management, in order to prevent adverse outcomes of the mothers and newborns.

表1 4组非治疗性早产患者一般情况的比较
表2 4组非治疗性早产患者妊娠结局的比较
表3 4组非治疗性早产患者新生儿结局的比较
[1]
谢杏,苟文丽. 妇产科学[M]. 8版. 北京:人民卫生出版社,2013: 58-60.
[2]
中华医学会妇产科学分会产科学组. 早产临产诊断与治疗指南[J]. 中华妇产科杂志,2014, 49(7):481-485.
[3]
蔡慧华. 急产的相关因素分析及预防措施[J]. 广东医学,2014, 35(3):407-409.
[4]
赵茵,邹丽. 自发性早产分娩时机和方式的选择[J]. 实用妇产科杂志,2012, 28(10):809-811.
[5]
蒋秀,崔世红. 198例早产资料的回顾性分析[J]. 中国妇幼保健,2014, 2(9):546-548.
[6]
杜培丽,张慧丽,何玉甜,等. 早产孕妇1963例临床结局分析[J]. 广东医学,2013, 10(34):1552-155.
[7]
许正先. 早产危险因素的病例对照研究[J]. 中国妇幼保健,2012, 27(35):5687-5690.
[8]
Langhof-fRoos J, Kesmodel U, Jacobsson B, et al. Spontaneous preterm delivery in primiparouswomen at low risk in Denmark: population based study[J]. BMJ, 2006, 332(7547): 9379-9391.
[9]
Torricelli M, Conti N. Epidemiology of early pre-term delivery:Relationship with clinical and his pathological infective parameters[J]. Obstet Gynaecol, 2013, 33(2):140-143.
[10]
麦凤鸣,陈敦金. 早产危险因素的研究[J/CD]. 中华产科急救电子杂志,2012, 1(2):103-107.
[11]
朱宇.≤孕34周早产分娩方式的研究[D]. 广州:第一军医大学,2007.
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