958例高龄初产妇妊娠结局分析

Analysis of the pregnancy outcome in 958 primipara aged 35 years or older

目的:了解高龄初产妇的妊娠结局。方法:对958例35岁以上高龄初产妇的相关资料进行回顾性分析,并与同期分娩的非高龄初产妇1050例进行对照研究。结果:高龄初产妇前置胎盘、妊娠高血压疾病、慢性高血压合并妊娠、妊娠期糖尿病、IGT、贫血、子宫肌瘤合并妊娠、剖宫产率显著高于非高龄组,产钳术占阴道分娩的比例显著高于非高龄组,顺产率显著低于非高龄组,而胎儿窘迫的发生率非高龄组显著高于高龄组。高龄组分娩孕周显著小于非高龄组,两组的早产率、新生儿窒息、转儿科率均无显著性差异;高龄组的新生儿畸形率比非高龄组有增高趋势,但无统计学差异;高龄组围产儿死亡和晚期流产率显著高于非高龄组,新生儿体重显著低于非高龄组。结论:高龄孕妇的妊娠合并症和并发症明显增多,晚期流产率高,剖宫产率高,阴道分娩者中助产率高,围产儿结局稍差,应加强围产保健以减少合并症和并发症的发生率。

Objective： To study the pregnancy outcome in primipara aged 35 years or older. Methods： The relevant informations of 958 cases of primipara aged 35 or older were analyzed retrospectively , 1 050 cases of primipara delivered at the same period aged less than 35 years were studied as control. Results： The rate of placental previa, pregnancy induced hypertension disease, chronic hypertension with pregnancy, gestational diabetes, impaired glucose tolerance test, anemia, uterine fibroids with pregnancy, cesarean section and forceps of vaginal delivery in the group aged 35 or older were significantly higher than that in the group aged less than 35 years, the rate of spontaneous delivery was opposite. But the rate of fetal distress was higher in women less than 35 years old. The delivery weeks in the older women was smaller and the rate of premature delivery , neonatal asphyxia and hospitalized in paediatric ward had no significant difference in two groups. The rate of neonatal abnormality in the group aged 35 or older was higher than that in the group aged less than 35 years, but it was no significance in statistics. The mortality of neonatal and late abortion rate in group aged 35 or older was higher than in group aged less than 35 years. And the weight of neonatal in group aged 35 or older was lower than in group aged less than 35 years. Conclusion： The incidence of pregnant complications , late abortion rate, cesarean section rate and forceps of vaginal delivery are higher in women aged 35 or ol- der. The outcome of neonatal is worse in women aged 35 or older. More perinatal care should be done for these pregnant women.