453例巨大儿相关因素分析及对分娩的影响

Study on Correlation Factors and Delivery Methods of Macrosomia:Analysis of 453 Cases

目的研究近4年来我院巨大儿的发生率、相关因素、分娩方式及并发症,以期进行早期预防,减少母婴并发症。方法对我院2005年1月-2008年12月分娩的453例巨大儿资料进行回顾性研究,并随机选择同期足月分娩的453例正常体重胎儿作为对照组进行比较。结果巨大儿发生率呈上升趋势（P〈0.01）;巨大儿组平均孕龄、孕末期体重、孕产次、宫高、腹围均高于对照组,差异有极显著性统计学意义（P〈0.01）。研究组中胎位异常、妊娠期糖尿病、胎膜早破、肩难产及剖宫产率明显增加,两组间差异均有极显著性（P〈0.01）。研究组中产后出血、新生儿窒息及宫缩乏力发生率均显著高于对照组,差异有统计学意义（P〈0.05）。结论巨大儿可增加母婴并发症,应积极进行早期预防,正确产前诊断并采用恰当的分娩方式。

Objective To explore the incidence,correlation factors,mode of delivery and complications of macrosomic infants in the recent four years in order to prevent and decrease the complications of mothers and neonates.Methods The clinical data of 453 cases of macrosomia from January 2005 to December 2008 were enrolled in the study,and pregnant women who delivered mature and normal weight fetus were randomly selected as control group.Results The incidence of macrosomia increased from 2005 to 2008（P〈0.01）.The occurrence of macrosomia had relations with mean gestational age,weight in the third trimester,the number of pregnancy and accouchement,height of the uterus and abdominal circumference of the mothers.The incidence of the abnormal position of fetus,gestational diabetes mellitus,premature rupture of membranes,shoulder dystocia and cesarean section were significantly higher in the macrosomia group than control group（P〈0.01）.There were significant differences of the incidence of the postpartum hemorrhage,asphyxia neonatorum and uterine inertia between two groups（P〈0.05）.Conclusions Macrosomia may increase the complications of mothers and neonates,measures such as early prevention,correct prenatal diagnosis and appropriate delivery should be adopted.