Advanced maternal age impacts pregnancy outcomes in placental abruption coupled with preeclampsia

doi:10.3877/cma.j.issn.2095-3259.2021.03.008

Abstract

Abstract:

Objective

To explore associations between advanced maternal age and obstetrical and neonatal outcomes of placental abruption coupled with preeclampsia in singleton pregnancies.

Methods

A retrospective study of 40 cases of placental abruption coupled with preeclampsia was performed and the subjects were collected from The Third Affiliated Hospital of Guangzhou Medical University between January 2017 and December 2019. Pregnant women were divided into two groups: advanced maternal age (AMA) group (≥35 years old) and control group (<35 years old). Data regarding maternal characteristics, laboratory evaluations, obstetrical and neonatal outcomes were compared between the groups.

Results

(1) Compared with control group, alanine transaminase (206.29±308.91) U/L, aspartate aminotransferase (279.86±449.01) U/L and serum creatinine (96.21±51.11) μmol/L and Urea (8.07±3.23) mmol/L were significantly higher. They also with higher systolic pressure and more maternal blood loss while the platelet was significantly lower in AMA group (P<0.05). The composite adverse neonatal outcomes including perinatal deaths and birth asphyxia were significantly higher in AMA group (P<0.05).

Conclusions

Placental abruption coupled with preeclampsia at AMA was associated with higher complication rates, such as maternal liver and kidney injury, as well as adverse neonatal outcomes.

Key words: Preeclampsia, Abruption placentae, Maternal age, Pregnancy outcomes

Huili Zhang, Wen Sun, Yongqiang Zhu, Lili Du, Lin Lin, Juanjuan Chen, Peili Du, Yanmei Zhou, Xueyuan Li, Dunjin Chen. Advanced maternal age impacts pregnancy outcomes in placental abruption coupled with preeclampsia[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2021, 10(03): 160-164.

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References 14

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分组	例数	孕前体重(kg，±s)	身高(cm，±s)	BMI(kg/m²，±s)	受孕方式		产前最高收缩压(mmHg，±s)
分组	例数	孕前体重(kg，±s)	身高(cm，±s)	BMI(kg/m²，±s)	自然受孕例(%)	IVF-ET术例(%)	产前最高收缩压(mmHg，±s)
高龄组	14	54.31±9.16	156.00±6.47	21.97±3.48	12(85.71)	2(14.29)	176.29±22.65
对照组	26	57.52±10.45	157.04±6.47	23.06±3.33	24(92.31)	2(7.69)	160.04±12.78
统计值		t＝-0.96	t＝-0.48	t＝-0.97	χ²＝0.01		Z＝2.48
P值		>0.05	>0.05	>0.05	>0.05		<0.05
分组	例数	产前最高舒张压(mmHg，±s)	产前最低收缩压(mmHg，±s)	产前最低舒张压(mmHg，±s)	产后出血量(ml，±s)	胎儿生长受限例(%)	母体其它严重并发症例(%)
高龄组	14	112.07±20.68	131.79±19.20	83.71±13.41	372.35±81.96	2(14.29)	8(57.14)
对照组	26	105.35±13.95	122.62±16.25	82.96±13.25	306.43±223.08	7(26.93)	7(26.92)
统计值		t＝1.23	t＝1.60	t＝0.17	Z＝-2.06	χ²＝2.95	χ²＝3.55
P值		>0.05	>0.05	>0.05	<0.05	>0.05	>0.05

分组	例数	孕前体重(kg，±s)	身高(cm，±s)	BMI(kg/m²，±s)	受孕方式		产前最高收缩压(mmHg，±s)
分组	例数	孕前体重(kg，±s)	身高(cm，±s)	BMI(kg/m²，±s)	自然受孕例(%)	IVF-ET术例(%)	产前最高收缩压(mmHg，±s)
高龄组	14	54.31±9.16	156.00±6.47	21.97±3.48	12(85.71)	2(14.29)	176.29±22.65
对照组	26	57.52±10.45	157.04±6.47	23.06±3.33	24(92.31)	2(7.69)	160.04±12.78
统计值		t＝-0.96	t＝-0.48	t＝-0.97	χ²＝0.01		Z＝2.48
P值		>0.05	>0.05	>0.05	>0.05		<0.05
分组	例数	产前最高舒张压(mmHg，±s)	产前最低收缩压(mmHg，±s)	产前最低舒张压(mmHg，±s)	产后出血量(ml，±s)	胎儿生长受限例(%)	母体其它严重并发症例(%)
高龄组	14	112.07±20.68	131.79±19.20	83.71±13.41	372.35±81.96	2(14.29)	8(57.14)
对照组	26	105.35±13.95	122.62±16.25	82.96±13.25	306.43±223.08	7(26.93)	7(26.92)
统计值		t＝1.23	t＝1.60	t＝0.17	Z＝-2.06	χ²＝2.95	χ²＝3.55
P值		>0.05	>0.05	>0.05	<0.05	>0.05	>0.05

分组	例数	B型利钠肽前体(pg/ml)	24 h尿蛋白定量(g/24 h)	血红蛋白(g/L)	血小板计数(×10⁹/L)	凝血酶原时间(s)	部分凝血酶原时间(s)	白蛋白(g/L)
高龄组	14	921.34±1214.45	1.60±2.26	109.50±20.36	124.86±87.53	9.83±0.55	31.96±9.23	29.72±4.30
对照组	26	424.53±509.35	3.77±4.23	118.62±11.81	211.65±56.42	9.74±0.77	27.76±2.27	28.35±4.94
统计值		Z＝-0.91	Z＝-1.99	t＝-1.80	Z＝-3.06	t＝0.39	Z＝-1.32	t＝0.88
P值		>0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05
分组	例数	纤维蛋白原(g/L)	抗凝血酶Ⅲ(%)	谷丙转氨酶(U/L)	AST(U/L)	血清肌酐(μmol/L)	血清尿素(mmol/L)	血清尿酸(μmol/L)
高龄组	14	3.50±1.11	63.71±21.19	206.29±308.91	279.86±449.01	96.21±51.11	8.07±3.23	516.39±141.57
对照组	26	3.82±0.73	69.83±21.75	17.25±9.36	22.94±8.11	63.88±14.09	7.54±11.86	487.79±98.93
统计值		Z＝-1.93	t＝-0.86	Z＝-2.61	Z＝-1.93	Z＝2.37	Z＝-2.27	t＝0.75
P值		>0.05	>0.05	<0.05	<0.05	<0.05	<0.05	>0.05

分组	例数	B型利钠肽前体(pg/ml)	24 h尿蛋白定量(g/24 h)	血红蛋白(g/L)	血小板计数(×10⁹/L)	凝血酶原时间(s)	部分凝血酶原时间(s)	白蛋白(g/L)
高龄组	14	921.34±1214.45	1.60±2.26	109.50±20.36	124.86±87.53	9.83±0.55	31.96±9.23	29.72±4.30
对照组	26	424.53±509.35	3.77±4.23	118.62±11.81	211.65±56.42	9.74±0.77	27.76±2.27	28.35±4.94
统计值		Z＝-0.91	Z＝-1.99	t＝-1.80	Z＝-3.06	t＝0.39	Z＝-1.32	t＝0.88
P值		>0.05	>0.05	>0.05	<0.05	>0.05	>0.05	>0.05
分组	例数	纤维蛋白原(g/L)	抗凝血酶Ⅲ(%)	谷丙转氨酶(U/L)	AST(U/L)	血清肌酐(μmol/L)	血清尿素(mmol/L)	血清尿酸(μmol/L)
高龄组	14	3.50±1.11	63.71±21.19	206.29±308.91	279.86±449.01	96.21±51.11	8.07±3.23	516.39±141.57
对照组	26	3.82±0.73	69.83±21.75	17.25±9.36	22.94±8.11	63.88±14.09	7.54±11.86	487.79±98.93
统计值		Z＝-1.93	t＝-0.86	Z＝-2.61	Z＝-1.93	Z＝2.37	Z＝-2.27	t＝0.75
P值		>0.05	>0.05	<0.05	<0.05	<0.05	<0.05	>0.05

分组	例数	出生孕周(周，±s)	新生儿出生体重(g，±s)	新生儿头围(cm，±s)	新生儿身长(cm, ±s)	围产儿性别[例(%)]
分组	例数	出生孕周(周，±s)	新生儿出生体重(g，±s)	新生儿头围(cm，±s)	新生儿身长(cm, ±s)	男婴	女婴
高龄组	14	29.86±5.16	1460.56±709.73	27.06±2.86	40.44±5.90	9(64.29%)	5(35.71%)
对照组	26	32.58±3.23	1720.63±733.77	29.06±2.65	41.54±5.15	12(46.15%)	14(53.85%)
统计值		Z＝-1.97	Z＝-1.21	t＝-1.90	t＝-0.52	χ²＝1.20
P值		>0.05	>0.05	>0.05	>0.05	>0.05
分组	例数	Apgar评分(1 min，±s)	Apgar评分(5 min，±s)	Apgar评分(10 min，±s)	新生儿不良预后[例(%)]
高龄组	14	7.44 ± 1.94	9.22 ± 0.67	9.44 ± 0.73	10(71.43)
对照组	26	8.61 ± 1.70	9.52 ± 0.79	9.78 ± 0.42	8(30.77)
统计值		Z＝-1.58	Z＝-1.38	Z＝-1.39	χ²＝-6.08
P值		> 0.05	> 0.05	> 0.05	<0.05

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