高龄妊娠晚期孕妇心电图变化与妊娠结局的研究

Study on electrocardiogram and pregnancy outcome in older late-stage pregnant women

目的探讨妊娠晚期高龄孕妇异常心电图变化与其对妊娠结局的影响。方法选取2014年1月至2016年6月在杭州市西溪医院进行产检及分娩的130例妊娠晚期孕妇,按照年龄分组,其中65例(年龄≥35岁)高龄孕妇为观察组,另选取65例(年龄<35岁)适龄孕妇为对照组。观察两组孕妇异常心电图发生率及心律失常类型;分析两组孕妇妊娠结局与异常心电图的关系。结果观察组孕妇异常心电图发生率(32.31%)显著高于对照组(15.38%),χ~2=5.125,P=0.024,差异有统计学意义(P<0.05);其中同时观察组心律失常(26.15%)、ST-T改变(12.31%)的发生率均高于对照组(9.23%,3.08%),差异具有统计学意义(χ~2值分别为6.392和3.900,均P<0.05);在心律失常类型方面比较,观察组窦性心动过速发生率显著高于对照组(χ~2=3.900,P=0.048);两组孕妇妊娠结局比较,观察组早产率显著高于对照组(χ~2=4.809,P=0.028),两组分娩方式及新生儿体重无显著差异;观察组剖宫产率(χ~2=4.775,P=0.029)、早产率(χ~2=4.188,P=0.041)及新生儿低体重率(χ~2=4.306,P=0.038)均显著高于对照组,差异均具有统计学意义(P<0.05)。结论高龄孕妇妊娠晚期易发生心律失常、ST-T改变等异常心电图改变;异常心电图高龄孕妇的剖宫产、早产及新生儿低体重发生率明显增加,临床上需要关注高龄孕妇妊娠晚期心电图变化,确保母婴安全。

Objective To explore the abnormal electrocardiogram （ECG） changes and their correlation with pregnancy outcomes in older late-stage pregnant women. Methods Altogether 130 late-stage pregnant women were selected in Hangzhou Xixi Hospital and divided into observation group with 65 eases （aged≥35） and control group with 65 cases （aged 〈 35 ）. The incidence of abnormal ECG and the types of arrhythmia were observed in two groups. The relationship between pregnancy outcomes and abnormal ECG of two groups was analyzed. Results The incidence of abnormal ECG in the observation group （32.31%） was significantly higher than that in the control group （15.38%） （χ2 = 5. 125 ,P =0.024）, and the difference was statistically significant （P 〈 0.05）. The incidences of arrhythmia （26.15%） and ST-T changes （ 12.31% ） in the observation group were higher than those in the control group with statistical significance （χ2 value was 6. 392 and 3. 900, respectively, both P 〈 0.05 ）. The incidence of sinus tachycardia in the observation group was significantly higher than in the control group （χ2 = 3. 900, P = 0. 048 ）. Focusing on pregnancy outcomes of women with normal ECG, the preterm birth rate of the observation group was higher than the control group （χ2 = 4. 809,P = 0. 028 ） , but there were no significant differences between two groups in delivery mode and neonatal birth weight. The cesarean section rate （χ2 = 4. 775, P = 0. 029）, preterm birth rate （χ2 = 4. 188,P = 0. 041 ） and low birth weight rate （χ2 = 4. 306, P = 0. 038） of the observation group were significant higher than those of the control group with statistical significance （ P 〈 0.05 ）. Conclusion Older pregnant women in late pregnancy are more susceptible to have abnormal ECG such as arrhythmia and ST-T changes. The incidence of caesarean section, preterm birth and low birth weight increases significantly in older late-stage pregnant women with abnormal ECG. More attention should be paid to ECG changes of older late-stage pregnant women to ensure the safety of mother and child.