产妇发生胎盘植入的危险因素Logistic回归分析

Logistic Regression Analysis on Risk Factors of Placenta Accreta Occurs on Puerpera

目的探讨产妇发生胎盘植入的危险因素,以期能为有效控制及减少胎盘植入的发生提供科学参考。方法回顾性分析9723例产妇临床资料,以发生胎盘植入的78例产妇为胎盘植入组,按照月份以1:2的比例抽取156例未发生胎盘植入的产妇为对照组,分析引起胎盘植入的相关危险因素。结果胎盘植入的发生率为0.80%(78/9723),粘连性胎盘植入占52.56%,植入性胎盘植入占47.44%,部分性胎盘植入占96.15%,完全性胎盘植入占3.85%;单因素分析文化程度、流产史、产次、合并前置胎盘、合并妊娠期高血压疾病、合并有产科合并症情况下产妇胎盘植入的发生风险性明显增加(P<0.05或P<0.01),多因素Logistic回归分析显示合并有前置胎盘、合并妊娠期高血压疾病是引起胎盘植入的独立危险因素(P<0.01)。结论引起产妇发生胎盘植入的独立危险因素为合并有前置胎盘及妊娠期高血压疾病,对以上危险因素进行干预可作为降低胎盘植入发生的一个干预方向。

Objective To investigate the risk factors of placenta accreta occurs on puerpera,so as to provide scientific reference for effectively control and reduce the incidence of placenta accreta.Methods To conduct a retrospective analysis on the clinical data of 9723 cases of puerpera.To take 78 cases of puerpera occurred placenta accreta as placenta implant group,and 156 cases of puerpera didn＇t occur placenta accreta were extracted as the control group according to the month in the ratio of 1：2,to analyze the related risk factors of placenta accreta.Results The incidence of placenta accreta was 0.80%（78/9723）,adhesions accounted for 52.56% of placenta accreta,placenta accreta plants accounted for 47.44%,partial placenta accreta accounted for 96.15%,complete placenta accreta accounting for 3.85 %.Univariate analysis showed that under the situations of educational level,history of abortion,parity,placenta previa,pregnancy induced hypertension,obstetric complications,the risk of the occurrance of placenta accreta was significantly increased（P〈0.05 or P〈0.01）,and multivariate Logistic regression analysis showed that associated with placenta previa,pregnancy induced hypertension is caused by placenta accreta were independent risk factors（P〈0.01）.Conclusion The independent risk factors of the cause of placenta accreta occurs on puerpera were associated with placenta previa and gestational hypertension,to conduct interventions on these risk factors can be an intervention direction to reduce the incidence of placenta accreta.