孕期发热对妊娠结局影响的研究

Study on Effects of Maternal Fever During Pregnancy Outcomes

目的 探讨孕期发热(体温>38℃)对妊娠结局的影响。方法 采用产科记录结合问卷调查,收集了北京市8所医院妇产科在1992年5月—1993年4月之间分娩的12224例初产妇妊娠及妊娠结局资料,并获取有关孕期发热及一般情况资料,从中抽取孕期曾有发热史的产例(发热组)以及孕期无发热史的产例(对照组)分别组成队列,分析孕期发热与不良妊娠结局有无关联,采用Logistic回归分析,调整产妇年龄、自然流产史、孕期患糖尿病史、孕期职业有害因素接触史、孕期吸烟、孕期饮酒等混杂因素。结果 孕期曾有发热史的产妇占产妇总数的9.7%。发热组先兆流产、早产、低出生体重儿、宫内发育迟缓、新生儿中枢神经系统畸形、新生儿窒息及新生儿死亡的发生率增高,与对照组比较,差异有显著性(P<0.05)。Logistic回归分析结果与单因素分析结果一致。结论 孕妇孕期发热(体温>38℃)与不良妊娠结局,特别是与新生儿中枢神经系统畸形的发生间具有一定关联。

OBJECTIVE To study the effects of maternal fever (temperature > 381) during pregnancy on pregnancy outcomes. METHODS Data of pregnancy outcomes were extracted from obstetric records of 12 224 primiparae in eight hospitials of Beijing during May 1992 to April 1993, maternal fever and other data about pregnancy in the study were interviewed. Cohort study was performed by selecting the cases of maternal fever during pregnancy as fever groups, and the cases of non- maternal fever during pregnancy as control group. The relationship between the pregnancy outcomes and maternal fever during pregnancy were analysed. The potential confounding factors such as age, history of spontaneous abortion, history of diabetes, exposed history to occupational hazards , smoking and drinking during pregnancy were adjusted with Logistic regression. RESULT The incidence of maternal fever during pregnancy was 9.6%.The results indicated that the incidence of thretened abortion, preterm labor, low birth weight, intrauterine growth retardation, neonatal asphyxia, neonatal death, neonatal malformation of central nervous system were significantly higher than that of the contral (P < 0.05). The result was the same after the confounders were adjusted by Logistic regression. CONCLUSION Adverse pregnancy outcomes, especialy malformation of central nervous system due to maternal fever (temperature > 381) during pregnancy has been found.