高龄孕产妇与适龄孕产妇围生期血液学检验指标变化及妊娠结局比较

Changes of Hematologic Indexes during Perinatal Period and Comparison of Pregnancy Outcome between Senile and Right-age Pregnant Women

目的比较高龄孕产妇与适龄孕产妇围生期血液学检验指标的变化及妊娠结局。方法选择2013年1月—2015年7月在无锡市锡山人民医院妇产科进行产前检查及分娩的600例高龄孕产妇作为观察组,选择同期600例适龄孕产妇作为对照组。检测并比较两组妊娠12周内、30~35周、38~42周及产后72 h内血常规、生化、凝血功能、血液流变学指标的变化情况,并记录妊娠伴发疾病、并发症发生情况及妊娠结局。结果两组围生期血常规及凝血功能指标比较差异均无统计学意义（P〉0.05）;妊娠中后期及产后72 h内观察组总胆固醇（TC）、甘油三酯（TG）显著高于对照组（P〈0.05）;整个围生期观察组血糖（BG）、高密度脂蛋白胆固醇（HDL-C）显著高于对照组（P〈0.01）,全血黏度（BV）、血浆黏度（PV）显著高于对照组（P〈0.05）。观察组妊娠期糖尿病、子宫肌瘤、妊娠高血压疾病、前置胎盘及产后出血发生率显著高于对照组（P〈0.01）;两组不良妊娠结局发生率差异无统计学意义（P〉0.05）。结论临床对高龄孕妇妊娠期应重点监测血脂、血糖及血液流变学指标,加强孕产期管理,有效监控妊娠伴发疾病及并发症,一旦发现及时干预,以最大限度改善妊娠结局。

Objective To compare the changes of hematologic indexes during perinatal period and pregnancy outcome between senile and right-age pregnant women.Methods A total of 600 senile pregnant women,who underwent prenatal examination and parturition during January 2013 and July 2015,were chosen as observation group,and 600right-age pregnant women at the same period were chosen as control group.The changes of hematologic indexes such as routine blood examination,biochemistry detection,blood coagulation and hemorheology were detected and compared in12,30-35 and 38-42 weeks of pregnancy and postpartum within 72 h in the two groups.The conditions of accompanied diseases,complications and pregnancy outcomes were recorded.Results There were no statistically significant differences in routine blood examination and blood coagulation during perinatal period in the two groups（ P〉0.05）.The levels of total cholesterol（ TC） and triglyceride（ TG） in mid-late pregnancy and postpartum within 72 h were significantly higher in observation group than those in control group（ P〈0.05）.Compared with those in control group,during the perinatal period the levels of blood glucose（ BG）,high-density lipoprotein（ HDL）,blood viscosity（ BV） and plasma viscosity（ PV） in observation group were significantly higher（ P〈0.05,P〈0.01）.The incidence rates of gestational diabetes,uterine fibroids,pregnancy-hypertension syndrome（ PIH）,placenta previa and postpartum hemorrhage were significantly higher in observation group than those in control group（ P〈0.01）.There were no statistically significant differences in incidence rate of adverse pregnancy outcomes in the two groups（ P〉0.05）.Conclusion Clinicians should closely monitor blood lipids,blood glucose and hemorheology and strengthen management in the period of gestation and parturition for the senile pregnant women.Meanwhile,pregnancy accompanied diseases and complications should be effectively monitored and timely interfered with in order to maximally improve the pregnancy outcome.