控制剖宫产率对高龄初产母婴结局影响的研究

Pregnancy outcomes in advanced maternal age pregnancies after taking measures to reducing caesarean section rate

目的探讨采取控制剖宫产率相关措施对高龄初产妇母婴结局的影响。方法回顾性分析1062例高龄初产孕产妇临床资料,2014年分娩的490例高龄初产妇作为研究组,2013年分娩的高龄初产妇572例作为对照组,比较两组妊娠并发症、分娩方式、产后出血率、新生儿窒息率。结果 1两组胎膜早破、妊娠期糖尿病、前置胎盘、子宫肌瘤、妊娠期高血压疾病、早产、巨大儿发生率差异无显著性(P>0.05);2研究组和对照组剖宫产率分别为51.63%、68.88%,两者比较差异有显著性(P<0.0001);3阴道助产率研究组与对照组分别为7.96%、4.72%,差异有显著性(P=0.02);4研究组产后出血率、输血率、新生儿窒息率与对照组相比,差异无显著性(P>0.05)。结论综合孕期和产时管理,将高龄初产孕妇剖宫产率控制在较合理的水平是可能的。

Objective To compare pregnancy outcomes in advanced maternal age pregnancies after taking measures to reducing caesarean section rate. Method A total of 1062 pregnant women aged 35 years or older who gave birth in beijing haidian district maternal and children healthcare hospital from 2013 to 2014 were retrospectively studied. 490 Pregnant women aged 35 years and over delivered in 2014 were included in study group and those 572 patients delivered in 2013 were included in the control group. Pregnant complications, delivery mode, postpartum hemorrhage rate,neonatal asphyxia rate were compared in both groups. Result ①No statistically significant difference was ob- served in the frequency of premature rupture of membrane, gestational diabetes mellitus, placenta previa, uterine my- oma,hypertensive disorders, preterm birth, or macrosomia in both groups; ②The caesarean section rate in study group was statistically significantly lower than that in the control group （51.63 % vs 68.88 %, P〈0. 0001 ） ;③ The instrumental delivery rate was significantly higher in study group than that in the control group （7.96% vs g. 72%, P=0.02） ;④ No statistically significant difference was observed in the frequency of postpartum hemorrhage, blood transfusion,neonatal asphyxia（P〉0.05 ）. Conclusion With the measures of strengthening prenatal and intrapartum care, it is possible to reducing the caesarean section rate in advanced maternal aged pregnancies.