2011—2015年承德市某医院早产、低出生体重儿发生情况及影响因素分析

THE ANALYSIS OF THE OCCURRENCE AND INFLUENCE FACTORS OF PREMATURE

目的了解承德市早产发生的现状和影响因素,为探讨可降低早产发生的干预措施提供依据。方法采用现况研究的方法,回顾性分析2011年1月—2015年12月在承德医学院附属医院住院分娩的孕周在26周及以上的活产单胎产妇8 094例,其中早产病例1 285例,足月分娩病例6 809例。内容包括产期保健情况、孕产期并发症/合并症等。产妇人口学特征、妊娠史、孕周采用χ2检验单因素分析以及Logistic回归多因素分析等方法进行统计分析。结果早产发生率为15.86%(1 285/8 094)。早产分娩孕周<27周者占0.7%(9/1 285),27~周者占18.52%(238/1 285),32~周者占22.64%(291/1 285)。34~37周者占58.13%(747/1 285),单因素分析显示不同年龄、不同职业、不同文化程度者发生率差异均有统计学意义,既往妊娠次数不同、既往分娩次数不同者的早产发生率差异均有统计学意义,多元Logistic回归分析,分别以早产、低出生体重、巨大儿、剖宫产为因变量,以单因素分析有统计学意义的指标为自变量进行多元Logistic回归分析,结果显示:年龄<20岁或>40岁、农民职业、文化程度低是早产发生的独立危险因素。结论影响早产发生的因素是多方面的,除进一步提高孕期保健质量,及时发现和处理孕期并发症/合并症外,积极孕前保健,流产后关爱也是减少早产的必要措施。故应把<20岁、>40岁、农民、低受教育程度这作为妊娠期健康教育的重点人群。

Objective To understand the current situation and influence factors of premature delivery in Chengde,and to provide the intervening measures basis for reducing the occurrence of premature delivery. Methods With the methods of cross - sectional survey,a retrospective analysis was conducted among 8094 puerperae who gave single and live births in author＇s hospital from Jan 2011 to Dee 2015.All the puerperae were including and above 26 gestational weeks, 1285 were cases of premature delivery and 6809 were term birth.The factors including the demographic characteristics of puerperae,histories of gestation, pregnant and perinatal care situation and pregnant and puerperal period complication were analyzed.？ 2 test and logistic multiple regression were used for statistical analysis.Results The incidence rate of premature delivery were 15.86% ,among which 0.7% （9/1285） were less than 27 gestational weeks. 18.52% （238/1285） of prema- ture delivery happened among puerperae between 27 to 32 weeks,and puerperae of 32 - 34 gestational weeks accounted for about 22.64% （291/1285） ,while those between 34 to 37 weeks occupied 58.13%（747/1285）. The single factor analysis showed that there were statistical significance in the difference of incidence when age,jobs,education level were taken into consideration. And the incidence rate difference between different number of pregnancies and number of deliveries was also different. The multiple logistic regression analysis took premature delivery,low birth weight, macrosomia and caesarean section as dependent variable,and those factors which showed statistical significance in single factor analysis as independent variable.The result shows that：age less than 20 or over 40 years old,peasants as job and lower education level were the risk factors of premature dehvery.Conclusion The influence factors of premature delivery are from many aspects.Other than improving the quality of antenatal care and discovering and disposing the gestational complications in time, positive preconception care and post - abortion care are also requisite measul＇e for reducing the occurrence of premature delivery.Thus pregnant women with the risk factors of less than the peasants with 20 or over 40 years old and with lower education level should be taken into gestational health education as focus people.