早孕胚胎停育与多种接触因素相关性研究及胚胎停育病因分析

Study on the correlations between embryo damage during early pregnancy and exposure to multiple factors and etiological analysis of embryo damage

目的探讨早孕胚胎停育与多种接触因素相关性和胚胎停育的病因。方法选取2015年1月-2017年1月在该院妇产科就诊的209例胚胎停育患者为研究组,另取同一时期在该院妇产科就诊的209例胚胎发育正常的孕妇作为对照组。在孕妇进行孕期检查时,在本人同意的情况下,让其填写《胚胎停育危险因素调查量表》,调查内容主要包括孕妇的基本情况、日常生活习惯、心理因素和不良环境接触因素等。结果对照组孕妇高文化水平人数显著高于研究组(P<0.05);研究组家庭月均收入(3 035.64±247.73)元显著低于对照组(4 864.21±276.41)元,差异有统计学意义(P<0.05);研究组有胚胎停育史的比例(29.19%)显著高于对照组(3.83%),差异有统计学意义(P<0.05);研究组常饮浓茶或喝咖啡和常喝酒的比例(30.62%、28.23%)显著高于对照组(10.05%、6.70%),差异有统计学意义(P<0.05);研究组在每天被动吸烟时长和烫染发次数方面显著高于对照组,在常参加体育锻炼人数和补充叶酸时间方面均显著低于对照组(P<0.05)。两组孕妇性格、情绪控制及孕后心情对比,差异均有统计学意义(均P<0.05),使用手机、使用电脑、使用微波炉和看电视因素比较,差异无统计学意义(P>0.05)。胚胎停育孕周8~12周和孕周>12周与孕周<8周的不良接触因素数量进行对比,差异无统计学意义(P>0.05)。结论饮浓茶或喝咖啡、被动吸烟、体育锻炼、喝酒、使用染发剂、家庭收入偏低等因素是导致胚胎停育的危险因素;孕前和孕期补充叶酸及适量的运动有利于胚胎的健康发育,防止胚胎停育;良好的性格、稳定的情绪和好的心情是胚胎停育的保护因素;胚胎停育的孕周与不良接触因素数量无明显相关性。

Objective To explore the correlations between embryo damage during early pregnancy and exposure to multiple factors and causes of embryo damage. Methods From January 2015 to January 2017,209 patients with embryo damage were selected from Department of Obstetrics and Gynecology in Baoji Municipal People＇s Hospital as study group,and 209 pregnant women with normal development of embryo were selected from Department of Obstetrics and Gynecology in the hospital as control group. In the context of informed consent,the cases were asked to finish risk factors questionnaire scale of embryo damage during pregnancy examination,the main research content included basic situation of pregnant women,daily habits,psychological factors,and exposure to adverse environmental factors. Results The number of women with high cultural level in control group was statistically significantly higher than that in study group（ P 0. 05）. The family monthly income in study group was（ 3 035. 64 ± 247. 73） Yuan,which was statistically significantly lower than that in control group[（ 4 864. 21±276. 41） Yuan]（ P0. 05）. The ratio of women with embryo damage history in study group was 29. 19%,which was statistically significantly higher than that in control group（ 3. 83%）（ P0. 05）. The percentages of women often drinking strong tea/coffer and alcohol were 30. 62% and 28. 23%,respectively,which were statistically significantly higher than those in control group（ 10. 05% and 6. 70%,respectively）（ P0. 05）. The time of passive smoking and times of permanent/hair coloring in study group were statistically significantly higher than those in control group,while the numbers of women often participating in physical exercise and supplementing folic acid in study group were statistically significantly lower than those in control group（ P0. 05）. There were statistically significant differences in maternal character,emotional control,and mood after delivery between the two groups（ all P0. 05）. There was no statistically significant difference in use of mobile phone,computer,microwave oven,and watching TV between the two groups（ P0. 05）. There was no statistically significant difference in the exposure numbers of adverse factors among the women with different gestational weeks of embryo damage（ 8-12 weeks,12 weeks,and 8 weeks）（ P0. 05）. Conclusion Drinking strong tea/coffer and alcohol,passive smoking,physical exercise,drinking,the use of hair dye,and low household income are risk factors of embryo damage. Supplementation of folic acid before and during pregnancy contributes to health development of embryo and prevention of embryo damage. Good character,stable mood,and good temper are protective factors of embryo damage. Gestational week of embryo damage is not correlated with the number of adverse factors.