不同孕妇年龄分娩方式及妊娠结局的分析

Analysis of Delivery Mode and Outcomes of Pregnancy with Different Ages

目的:分析孕妇年龄对妊娠结局的影响。方法:采用回顾性对照研究,分析2015年1月~6月在某院分娩的8835例孕妇的临床资料,根据年龄分为5组:20~24岁组、25~29岁组、30~34岁组、35~39岁组、≥40岁组,比较各年龄组分娩方式、剖宫产手术指征及妊娠合并/并发症的发生率的差异。其中剖宫产手术指征根据罗伯特十分类法进行统计记录。结果:5组共4181例孕妇施行剖宫产术(剖宫产率47.32%),随着分娩年龄的增加,剖宫产率分别为34.42%、41.58%、55.47%、69.70%、78.16%,RR 2.56,95%CI值2.45~3.12,P<0.001,剖宫产率差异显著,明显升高;剖宫产手术指征按照十分类法(TGCS)分类,除第7类手术指征(所有单胎臀位经产妇,含前剖)各年龄组剖宫产率无差异,其余9组各年龄组剖宫产率均差异具有显著性。子痫前期、前置胎盘、妊娠期糖尿病的发生率由5.4%、1.9%、7.0%升高至20.7%、11.5%、40.2%,差异显著。结论:随年龄增长,剖宫产率、妊娠合并症的发生率均增加。而胎膜早破、产后出血的发生率差异无显著性。

Objective： To explore the relationship pregnancy outcome and the age of pregnant woman, Methods： A retrospective population-based cohort study was conducted using delivery data of 8835 pregnancies records in Hubei maternal and child health hospital from January to JUne in 2015, The Cases were divided into five groups according to their age（ 20-24 years, 25-29years, 30-34years, 35-39 years and 40 or older） to compare the difference of delivery modes, the indication of cesarean section and the incidence of pregnancy complications between different groups. The indication of cesarean section was recorded according to Robert ten classification. Results： The number of women who received caesarean section （CS） in all groups were 4181 and the CS rate was 47.32%. With the increase of age, the cesarean section rate of five-age-group was 34.42%, 41.58%, 55.47%, 69.70%, respectively（RR2.56, 95% CI2.45-3.12, P〈0.001）. The cesarean section rate increased obviously and the difference was significant. The indication of cesarean section was classified by TGCS, and there was no difference in the cesarean section rate of all groups except category 7 indications （all monotocous pregnancies including previous CS）. The incidence of preeclampsia, placenta previa and gestational diabetes increased from 5.4%, 1.9%, and 70% to 20.7%, 11.5%, and 40.2% respectively. Conclusion： With the increase of age, the rate of cesarean section and the incidence of pregnancy complica tions are increased. There is no significant difference in the incidence of premature rupture of membranes and postpartum hemorrhage.