早产高危因素分析

Risk Factors of Premature Delivery and Its Prevention and Treatment

目的分析早产有关高危因素,以寻求相应的防治措施.方法回顾性分析2002年1月～2005年5月我院早产总数212例,分为被迫性早产与自然早产两组,分别与同期足月分娩的200例相比,对照分析早产高危因素.结果早产组与足月分娩组孕母年龄差异元显著性,人工流产次数、产前检查次数、妊娠期高血压疾病、胎儿窘迫、妊娠期肝内胆汁淤积症、多胎妊娠、胎膜早破、产前出血及胎位异常均与早产有关,妊娠期高血压疾病,胎儿窘迫,妊娠期肝内胆汁淤积症,多胎妊娠占据被迫性早产病因前四位主要产前危险因素.而自然早产的主要产前危险因素为胎膜早破和不明原因早产.结论被迫性早产与自然早产具有不同的高危因素;减少早产的发生率关键是重视围产期保健,加强对高危妊娠的管理,积极防治产前并发症.

Objective The risk factors associated with premature delivery were analyzed and the measures to prevent premature delivery were explored. Methods Two hundred full - term deliveries and 212 premature deliveries including 134 spontaneous premature deliveries and 78 compelled premature deliveries during Jan. 2002 through May 2005 were compared to analyze the risk factor of premature delivery. Results Maternal age did not vary significantly between the full- term delivery and premature delivery group. Factors associated with premature delivery included frequency of prenatal examination, frequency of previous induced abortion, pregnant- induced hypertension, fetal distress, intrahepatic cholestasis of pregnancy, premature rupture of membranes, multiple pregnancies, antepartum hemorrhage and fetal abnormal presentations. The preceding risk factors of compelled premature delivery were pregnant- induced hypertension, fetal distress, intrahepatic cholestasis of pregnancy, multiple pregnancies. The major risk factors for spontaneous premature delivery were premature rupture of membrane and idiopathic premature delivery. Conclusion There are multiple risk factors associated with premature delivery, and spontaneous premature delivery and compelled premature delivery have different risk factors; the key issue to reduce the incidence of premature delivery is to attach attention to perinatal care, improve the management of high risk gestation and establish guidelines to prevent complications.