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中华产科急救电子杂志

中华产科急救电子杂志 ›› 2016, Vol. 05 ›› Issue (03) : 173 -177. doi: 10.3877/cma.j.issn.2095-3259.2016.03.011

所属专题： 文献；

论著

高龄妊娠对胎儿疾病的影响
王春燕1, 龚景进1, 李思慧1, 王晓燕2, 陈敦金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
    2. 510180　广州医科大学市一临床学院
  • 收稿日期:2016-06-22 出版日期:2016-08-18
  • 通信作者: 陈敦金
  • 基金资助:
    广州市教育局协同创新重大项目(13xt04); 广州市科技惠民专项项目(2014Y2－00182); ROS－ERS－EMT在PM2.5母源性暴露致子代肺间质病变中的作用机制(81571518); 产科重大疾病防控创新团队(2015KCXTD020)

Impact of pregnant women with advanced age on fetal disease

Chunyan Wang1, Jingjin Gong1, Sihui Li1, Xiaoyan Wang2, Dunjin Chen1,†()   

  1. 1. Department of Obstetrics and Gynecology, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou Medical Centre for Critical Pregnant Women, Guangzhou 510150, China
    2. The Clinical College of Guangzhou First People′s Hospital, Guangzhou Medical University, Guangzhou 510180, China
  • Received:2016-06-22 Published:2016-08-18
  • Corresponding author: Dunjin Chen
  • About author:
    Corresponding author: Chen Dunjin, Email:
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引用本文：

王春燕, 龚景进, 李思慧, 王晓燕, 陈敦金. 高龄妊娠对胎儿疾病的影响[J]. 中华产科急救电子杂志, 2016, 05(03): 173-177.

Chunyan Wang, Jingjin Gong, Sihui Li, Xiaoyan Wang, Dunjin Chen. Impact of pregnant women with advanced age on fetal disease[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2016, 05(03): 173-177.

目的

探讨高龄妊娠对胎儿疾病的影响。

方法

回顾性分析2009年1月至2014年12月在广州医科大学附属第三医院妇产科分娩的28 897例单胎孕妇的临床资料。按照年龄分为≥35岁组(3 670例)和18～34岁组(25 227例)。分析两组孕妇胎儿疾病的发生情况，采用卡方检验及U检验对数据进行统计学分析。

结果

纳入研究的单胎孕妇中年龄≥35岁组占12.70%，18～34岁组占87.30%。≥35岁组胎儿疾病总发生率显著高于18～34岁组(2.62%与2.04%，χ2＝5.106，P＝0.024)。≥35岁组死胎、胎儿染色体异常和多发畸形发生率分别为1.66%、0.57%和1.36‰，也明显高于18～34岁组的1.41%，0.12%和0.44‰，P均<0.05。

结论

高龄孕妇死胎、胎儿染色体异常、多发畸形发生率增高。

关键词: 母亲年龄, 胎儿疾病, 死胎, 染色体畸变, 先天畸形
Objective

To explore the impact of pregnant women with advanced age on fetal disease.

Methods

A clinical data of 28 897 singleton pregnancies who delivered from January 2009 to December 2014 in The Third Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. According to the maternal age, all cases were divided into ≥35 years group (n=3 670), and 18-34 years group (n=25 227). The fetal disease rates of two the groups were analyzed by Chi-square test and U test.

Results

The percentage of singleton pregnancies at the age of 35 years and older was 12.70%, and the percentage of patients between 18 and 34 was 87.30%. The rate of total fetal diseases in ≥35 years group was higher than that in 18-34 years group (2.62% and 2.04%, χ2=5.106, P=0.024). And the rates of fetal death, fetal chromosome abnormality and fetal multiple malformations in ≥35 years group (1.66%, 0.57% and 1.36‰, respectively) were higher than those in 18-34 years group (1.41%, 0.12% and 0.44‰), P values less than 0.05.

Conclusion

The rates of fetal death, fetal chromosome abnormality and fetal multiple malformations increase in pregnancies with advanced age.

Key words: Maternal age, Fetal diseases, Fetal death, Chromosome aberrations, Congenital abnormalities
表1 两组产妇基本资料比较
组别 例数 孕次(次，±s) 产次(次，±s) 体重指数(kg/m2，±s) 辅助生殖技术授孕
例数 千分率(‰)
≥35岁组 3 670 2.78±1.55 0.62±0.72 23.80±3.27 73 19.89
18～34岁组 25 227 1.84±1.10 0.26±0.52 22.16±3.09 365 14.47
统计值 ? U＝2.854 U＝3.298 U＝1.174 χ2＝6.311
P值 ? 0.000 0.000 0.000 0.012
图1 ≥35岁孕妇5个年龄段胎儿疾病和死胎发生率
表2 两组胎儿染色体异常和多发畸形情况比较
组别 例数 染色体异常 21-三体综合征 18-三体综合征 多发畸形
例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰)
≥35岁组 3 670 21 5.72 13 3.54 4 1.09 5 1.36
18～34岁组 25 227 30 1.19 15 0.59 6 0.24 11 0.44
χ2值 ? 37.368 28.757 6.730 4.968
P值 ? 0.000 0.000 0.009 0.026
表3 两组胎儿其他疾病发生情况比较
组别 例数 先天性心脏病 Duang-Walker综合征 单脐动脉 唇腭裂
例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰)
≥35岁组 3 670 17 4.63 2 0.54 10 2.72 7 1.91
18～34岁组 25 227 117 4.64 12 0.48 35 1.39 40 1.59
χ2值 ? 0.000 0.032 3.686 0.204
P值 ? 0.996 0.859 0.055 0.651
组别 例数 多囊肾 四肢畸形 消化系统畸形 中枢神经系统畸形
例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰) 例数 千分率(‰)
≥35岁组 3 670 2 0.54 2 0.54 5 1.36 4 1.09
18～34岁组 25 227 14 0.55 6 0.24 18 0.71 21 0.83
χ2值 ? 0.001 1.092 1.696 0.246
P值 ? 0.981 0.296 0.139 0.620
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