2011—2015年承德市某医院巨大胎儿发生情况及影响因素分析

THE ANALYSIS OF FETAL MACROSOMIA IN A CERTAIN HOSPITAL IN CHENGDE CITY FROM 2011 TO 2015

目的了解承德市某医院巨大胎儿的发生情况和影响因素,为探讨可降低巨大胎儿发生的干预措施提供依据。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1 285例,足月分娩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、妊娠史采用χ~2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。结果巨大胎儿发生率为11.26%(912/8 094)。2011—2015年,巨大胎儿的发生率差异无统计学意义,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、既往分娩次数与巨大胎儿发生率差异无统计学意义;多元Logistic回归分析,以巨大胎儿为因变量,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,文化程度高、高龄是巨大胎儿发生的独立危险因素。结论适宜生育年龄的高学历人群及高龄孕产妇是巨大胎儿的高发因素,对这一类人群更应该严格管理重点预防,从而改善妊娠结局。

Objective To comprehend the current situation and influence factors of fetal macrosomia in ChengDe,so as to provide the basis for discussing the intervening measures to reduce the occurrence of fetal macrosomia.Methods With the methods of cross-sectional survey,retrospective analysis was conducted among 8094 puerperae who gave single and live births in author＇s hospital from Jan 2011 to Dec 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 single factor analysis and logistic multiple regression analysis were used for statistical analysis.Results The incidence rate of fetal macrosomia was 11.26%（912/8094）,there was no statistically significant difference between 2011 and 2015.The single factor analysis showed that there were statistical significance in the difference of incidence when age,jobs,education level were taken into consideration.There was no statistically significant difference in the number of pregnancies,the number of births and the incidence of fetal macrosomia.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 results showed that high literacy was an independent risk factor for fetal macrosomia.Conclusion People with a high degree of childbearing age are the high risk factors for large foetus,and they should be strictly controlled to prevent them,thus improving the outcome of pregnancy.