异位妊娠发生影响因素的病例对照研究

Case control study on influence factors of ectopic pregnancy

目的研究异位妊娠发生的危险因素，为预防和控制异位妊娠的发生提供理论依据。方法回顾性收集我院2011年1月～2013年3月期间异位妊娠的患者资料，同期收集正常孕妇的资料进行对比，采用病例对照的方法，研究影响异位妊娠的影响因素。结果对婚姻状况、初孕年龄、文化程度、孕产史、流产史、异位妊娠史、腹部手术史、妇科疾病史等因素进行单因素分析表明初孕年龄（Х^2=13．36，P〈0．05）、孕产史（Х^2=176．61，P〈0．05）、流产史（Х^2=28．18，P〈0．05）、异位妊娠史（Х^2=10．41，P〈0．05）、腹部手术史（Х^2=7．32，P〈0．05）、妇科疾病史（Х^2=33．10，P〈0．05）等是影响异位妊娠发生的危险因素；多元，多元Logistic回归模型进行分析表明，初孕年龄（OR=2．21，95％CI1．58～3．57）、孕产史（OR=4．18，95％CI：2．16—6．54）、流产史（OR=3．97，95％CI：1．87～5．29）、异位妊娠史（OR=I．56，95％CI：1．15～2．66）、妇科疾病史（OR=2．57，95％CI：1．94～4．87）是异位妊娠发生的独立危险因素。结论异位妊娠的发生是多种因素综合作用的结果，加强健康教育，减少非意愿妊娠和预防妇科疾病是降低异位妊娠发病率的重要措施。

Objective To study the risk factors of ectopic pregnancy in order to provide the theoretical foundation for ectopic pregnancy prevention and control. Methods The information of patients with ectopic pregnancy in our hospital during January 2011 to March 2013 was retrospectively collected and the information of normal pregnant women were collected during the same period and compared. The influence factors of ectopic pregnancy were studied by using case control method. Results The univariate analysis on marital status, first-time pregnant age, educational level, pregnancy-labor history, abortion history, ectopic pregnancy history, abdominal surgery history and gynecological diseases history showed that the factors such as first-time pregnant age（Х^2=13.36,P 〈 0.05）, pregnancy- labor history（Х^2=176.61, P 〈 0.05）, abortion history（Х^2=28.18, P 〈 0.05）, ectopic pregnancy history（Х^2=10.41, P 〈 0.05）, abdominal surgery history（Х^2=7.32, P 〈 0.05） and gynecological diseases history（Х^2=33.10, P 〈 0.05） were the risk factors of ectopic pregnancy. The analysis of multivariate Logistic regression models showed that first- time pregnant age （ 0R=2.21,95%CI： 1.58-3.57 ）, pregnancy-labor history（OR=4.18,95%CI： 2.16-6.54）, abortion history（OR=3.97,95%Cl： 1.87-5.29）, ectopic pregnancy history（OR= 1.56,95%CI： 1.15-2.66）, gynecological diseases history（OR=2.57,95%Cl： 1.94-4.87）were independent risk factors for ectopic pregnancy. Conclusion Ectopic pregnancy is the comprehensive result of multiple factors, enhancing health education, reducing unintended pregnancy and preventing gynecological diseases are important measures to reduce the incidence of ectopic pregnancy.