前置胎盘相关因素的病例对照及妊娠结局临床分析

Clinical analysis of the case-control of placenta previa related factors and pregnancy outcome

目的探讨前置胎盘的相关因素及其对妊娠结局的影响。方法选择2012年1月—2015年10月住院待产的前置胎盘产妇79例为研究组,按照1∶2的比例匹配同期住院的158例健康产妇为对照组。对比两组相关因素的暴露情况及妊娠结局。计数资料采用χ-2检验,危险因素分析采用Logistic回归分析,P〈0.05为差异有统计学意义。结果年龄（OR=2.647,95%CI为1.707-4.105）、流产史（OR=3.245,95%CI为1.661-6.338）、剖宫产史（OR=3.500,95%CI为1.106-11.072）是前置胎盘发生的独立危险因素。文化程度（OR=0.653,95%CI为0.433-0.983）是保护因素。研究组的胎盘粘连植入、产后出血、低体重儿及早产儿发生率分别为11.39%、18.99%、22.78%和16.46%,均明显高于对照组的1.90%、5.70%、7.59%和5.70%,差异均有统计学意义（均P〈0.05）。结论孕产妇高龄、流产史和剖宫产史是前置胎盘的危险因素,文化程度是保护因素,前置胎盘孕妇的预后差。加强生殖健康宣教活动,减少非意愿妊娠和流产,严格控制剖宫产指征,可降低前置胎盘发生率,从而改善妊娠结局。

Objective To investigate the related factors of placenta preyia and its effect on the pregnancy outcome Methods This article studies 79 cases of placenta previa from January 2012 to October 2015 as the research group, while 158 cases of healthy pregnant women as the control group based on the ratio of 1：2 over the same period in hospital, to compare two groups＇ exposure of relative factors and pregnancy outcome. Count data was processed by chi square test, Logistic regression analysis was used for risk factor, P〈0.05 was considered statistically significant. Results The results indicated that age（OR=2.647, 95%CI 1.707-4.105）,abortion（OR=3.245, 95%CI 1.661-6.338）,and cesarean section （0R=3.500, 95%CI 1.106＂11.072） were independent risk factors of placenta previa, but educational level（OR=0.653, 95%CI 0.433-0.983）was protective factor. In the study group, the rate of the implantation of placenta accreta, postpartum hemorrhage, low birth weight as well as preterm delivery were 11.39%,18.99%,22.78% and 16.46%, higher than the control group （1.90%,5.70%,7.59% and 5.70%）,the differences were statistically significant（all P〈0.05）.Conclusion The risk factors of placenta previa were high pregnancy age, abortion and cesarean section, but the protective factor was educational level. The rate of the incidence of placenta previa can be declined by strengthening reproductive healthy education activities, reducing unwanted pregnancies and abortions, strictly controlling the cesarean section. By those measures,the pregnancy outcome can be improved.