特发性羊水减少孕妇早产情况及相关因素研究

Preterm Delivery due to Idiopathic Oligohydraminos and Borderline Amniotic Fluid Inedx and Its Related Factors

目的：了解特发性羊水减少孕妇早产情况，探讨其临床特征及相关因素。方法选择2009-2013年在温州医科大学附属第一医院分娩的资料完整的单胎妊娠孕妇82例，均符合特发性羊水减少诊断标准〔孕28~36＋6周羊水指数（AFI）≤8.0 cm〕；根据早产情况将所有孕妇分为早产组21例和足月产组61例，比较两组孕妇妊娠期情况、分娩情况及围产儿结局。结果本组孕妇早产发生率为25.61%（21/82）；早产分类：治疗性早产13例，未足月胎膜早破（PPROM）早产及自发性早产各4例；早产分期：早期早产2例，中期早产1例，晚期早产18例。早产组孕妇羊水减少确诊时 AFI 低于足月产组（P é0.05），其他妊娠并发症发生率高于足月产组（P é0.05）。早产组孕妇分娩孕周、分娩前 AFI、引产率低于足月产组（P é0.05）。早产组新生儿体质量低于足月产组（P é0.01），围产儿不良结局发生率高于足月产组（P é0.01）。Pearson 相关性分析结果显示，早产与分娩前 AFI 呈负相关（r =-0.65，P é0.01），围产儿不良结局与羊水减少确诊时 AFI、分娩前 AFI 及分娩孕周呈负相关（ r =-0.32、-0.35、-0.47，P é0.05）。结论特发性羊水减少孕妇早产发生率较高，且与分娩前 AFI 呈负相关，以治疗性早产及晚期早产为主；特发性羊水减少孕妇如并发早产，围产儿不良结局发生率增加，且与羊水减少确诊时 AFI、分娩前 AFI 及分娩孕周呈负相关。

Objective To analyze the preterm delivery of pregnant women with idiopathic oligohydraminos（IO）and borderline amniotic fluid inedX（AFI）,and eXplore its clinical features and related factors. Methods Eighty - two monocyesis pregnant women who delivered in the First Affiliated Hospital of Wenzhou Medical University from 2009 to 2013,and were in line with the diagnostic criteria of IO and borderline AFI〔28 - 36 ＋ 6 weeks of pregnancy AFI≤8. 0 cm〕were divided into groups pre-term birth（PTB group,n = 21）,full - term（FT group,n = 61）. The trimesters of pregnancy,childbirths and perinatal out-comes were compared between 2 groups. Results The incidence of PTB was 25. 61% （21 / 82）. Thirteen pregnancy women had therapeutic PTB,4 had preterm premature rupture of membranes（PPROM）,4 had spontaneous PTB. Two had early PTB,1 had mid - PTB,18 had late PTB. The AFI at diagnosis was lower in PTB group than in FT group（P é 0. 05）. The incidences of the other pregnancy complications were higher（P é 0. 05）,the gestational weeks,predelivery AFI,laber induction rate lower in PTB group than in FT group（P é 0. 05）. The newbornsˊ weight were lower in PTB group than in FT group（P é 0. 01）,the incidence of perinatal adverse outcomes higher（P é 0. 01）. By Pearson correlation analysis,the AFI of preterm was negatively correlated with that of predelivery（r = - 0. 65,P é 0. 01）,perinatal adverse outcomes negatively with AFI at IO and borderline AFI diagnosis,before delivery and gestational weeks（r = - 0. 32, - 0. 35, - 0. 47,P é 0. 05）. Conclusion PTB,the in-cidence of which is high in IO and borderline AFI pregnancy women,is negatively correlated with AFI before delivery and mainly therapeutic and late ones. The incidence of perinatal adverse outcomes increases in IO and borderline AFI pregnancy women and is negatively correlated with AFI before delivery and gestational weeks.