中央性前置胎盘高危因素及结局的病例对照研究

High-risk factors and pregnancy outcome for central placenta previa: a case-control study

目的：探讨中央性前置胎盘发生的高危因素及其对妊娠结局的影响。方法：对我院283例中央性前置胎盘患者和126例正常剖宫产孕产妇进行病例对照研究。结果：病例组孕产妇的人工流产史、自然分娩史高于对照组（P〈0.05）,而病例组孕周、产检次数低于对照组（P〈0.05）。病例组产后出血、胎盘粘连、胎盘植入、贫血等妊娠结局发生率均高于对照组（P〈0.05）,而胎心和出生体重低于对照组（P〈0.05）。非条件Logistic回归分析表明,产检次数（OR=0.586,95%CI：0.515~0.666）是中央性前置胎盘的保护因素,人工流产（OR=1.843,95%CI：1.152~2.947）是危险因素。结论：中央性前置胎盘能增加不良妊娠结局的发生率;产检次数可以降低中央性前置胎盘发生风险,人工流产能增加其发生风险。

Objective： To explore the high-risk factors of central placenta previa and its adverse effects on pregnancy outcome. Methods： 283 pregnant and parturient women with central placenta previa were chosen as case group. 126 normal cesarean section cases without central placenta previa during the same period were randomly selected as control group. The high-risk factors and adverse effects on central placenta previa were in the comparison between two groups.Results： Compared with control group,the rate of artificial abortion and natural delivery in the case group were significantly higher（ P 0. 05）,and the gestational weeks and the frequency of antenatal examination were significantly lower（ P 0.05）. The rate of postpartum hemorrhage,adherent placenta,placenta accrete and anemia in the case group were higher than those in the control group（ P 0. 05）,but fetal heart and birth weigh were lower（ P 0. 05）. Logistic regression analysis revealed that antenatal examination（ OR = 0. 586,95% CI： 0. 515-0. 666） may be the protective factors for central placenta previa,and artificial abortion（ OR = 1. 843,95% CI： 1. 152-2. 947） may be the risk factors for central placenta previa.Conclusion： Central placenta previa can increase the incidence of adverse pregnancy outcome. The frequency of antenatal examination may reduce the risk of central placenta previa,and artificial abortion may increase the risk.