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中华产科急救电子杂志 ›› 2026, Vol. 15 ›› Issue (03) : 167 -174. doi: 10.3877/cma.j.issn.2095-3259.2026.03.007

论著

胎儿生长受限孕妇血栓前状态与妊娠结局的研究
陈陆静1, 李飞燕1, 李庄1, 曹亚聪1, 冀晓慧2, 陈慧2, 郭义红1, 周萍1,()   
  1. 1东莞市妇幼保健院生殖免疫科,东莞 523000
    2中山大学孙逸仙纪念医院妇产科,广州 510000
  • 收稿日期:2025-09-01 出版日期:2026-08-18
  • 通信作者: 周萍

A study on prethrombotic state and pregnancy outcomes in pregnant women with fetal growth restriction

Lujing Chen1, Feiyan Li1, Zhuang Li1, Yacong Cao1, Xiaohui Ji2, Hui Chen2, Yihong Guo1, Ping Zhou1,()   

  1. 1Department of Reproductive Immunology, Dongguan Maternal and Child Health Hospital, Dongguan 523000, China
    2Department of Obstetrics and Gynecology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510000, China
  • Received:2025-09-01 Published:2026-08-18
  • Corresponding author: Ping Zhou
引用本文:

陈陆静, 李飞燕, 李庄, 曹亚聪, 冀晓慧, 陈慧, 郭义红, 周萍. 胎儿生长受限孕妇血栓前状态与妊娠结局的研究[J/OL]. 中华产科急救电子杂志, 2026, 15(03): 167-174.

Lujing Chen, Feiyan Li, Zhuang Li, Yacong Cao, Xiaohui Ji, Hui Chen, Yihong Guo, Ping Zhou. A study on prethrombotic state and pregnancy outcomes in pregnant women with fetal growth restriction[J/OL]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2026, 15(03): 167-174.

目的

探讨胎儿生长受限(fetal growth restriction, FGR)孕妇血栓前状态异常检出率、高危因素及其与妊娠结局的关系。

方法

采用回顾性研究方法,对我院2024年1至12月收治的182例FGR孕妇的年龄、孕前体重指数、受孕方式、既往孕产史、首次发现FGR孕周、接受血栓前状态检测孕周、妊娠期并发症和合并症、TORCH筛查、产前筛查或产前诊断结果、孕期用药情况、妊娠结局等进行分析。检测抗磷脂抗体谱、抗核抗体、蛋白C/S、抗凝血酶Ⅲ、同型半胱氨酸等指标,按检测结果分为异常组(99例)与正常组(83例),比较组间临床特征及妊娠结局。

结果

54.4%的FGR孕妇存在血栓前状态异常;异常组抗心磷脂抗体IgM、抗β2糖蛋白Ⅰ抗体IgM、狼疮抗凝物初筛/确认比值、抗磷脂酰丝氨酸/凝血酶原抗体IgM均高于正常组,抗凝血酶Ⅲ活性和蛋白S水平低于正常组,差异具有统计学意义(P值均<0.05);年龄(OR=1.10, 95%CI:1.01~1.20)和孕前高体重指数(OR=1.10, 95%CI:1.00~1.22)是血栓前状态的独立危险因素。

结论

高龄和孕前高体重指数是FGR孕妇血栓前状态检测异常的独立高危因素,检出率高,建议高龄和孕前高体重指数的FGR孕妇进行血栓前状态检测,以改善妊娠结局。

Objective

To investigate the detection rate and risk factors of abnormal prethrombotic state and its association with pregnancy outcomes in pregnant women with fetal growth restriction.

Methods

A retrospective study was conducted on 182 pregnant women with FGR treated at our hospital from January to December 2024. Data collected included maternal age, pre-pregnancy body mass index (BMI), mode of conception, obstetric history, gestational age at first FGR diagnosis, gestational age at prethrombotic state testing, pregnancy complications and comorbidities, TORCH screening results, prenatal screening or diagnostic findings, medication during pregnancy, and pregnancy outcomes. Laboratory tests included antiphospholipid antibody profiles, antinuclear antibodies, protein C/S, antithrombin Ⅲ (AT-Ⅲ), and homocysteine levels. Patients were divided into an abnormal group (n=99) and a normal group (n=83) based on test results. Clinical characteristics and pregnancy outcomes were compared between the two groups.

Results

Prethrombotic state abnormalities were detected in 54.3% of FGR pregnant women. Compared with the normal group, the abnormal group had significantly higher levels of anticardiolipin antibody IgM, anti-β2-glycoprotein I antibody IgM, lupus anticoagulant screening/confirmatory ratio, anti-phosphatidylserine/prothrombin antibody IgM, and antinuclear antibodies, along with significantly lower levels of AT-Ⅲ activity and protein S, with all differences being statistically significant (all P<0.05). Multivariate logistic regression analysis identified maternal age (OR=1.10, 95%CI: 1.01-1.20) and high pre-pregnancy BMI (OR=1.10, 95%CI: 1.00-1.22) as independent risk factors for prethrombotic state abnormalities.

Conclusions

Advanced maternal age and high pre-pregnancy BMI are independent risk factors for prethrombotic state abnormalities in pregnant women with FGR, with a high detection rate. Screening for prethrombotic state is recommended in FGR patients with these risk factors to improve pregnancy outcomes.

表1 182例胎儿生长受限孕妇一般资料
表2 182例胎儿生长受限孕妇实验室检测结果
表3 血栓前状态检测异常组和正常组一般资料的比较
表4 血栓前状态检测异常组和正常组检测结果的比较
表5 血栓前状态检测异常组和正常组分娩结局和新生儿结局的比较
表6 血栓前状态检测异常组和正常组比较二元Logistic回归单因素分析
表7 血栓前状态检测异常组和正常组比较二元Logistic回归多因素分析
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