高龄经产妇及初产妇妊娠期并发症及妊娠结局比较

Comparison of pregnancy complications and pregnancy outcomes between elderly multiparous women and primiparous women

目的比较高龄经产妇及初产妇妊娠期并发症及妊娠结局情况。方法选取2010年1月-2017年8月在核工业四一六医院住院分娩的715例高龄产妇为研究对象,根据分娩史将其分为观察组(经产妇)与对照组(初产妇),比较两组产妇妊娠期并发症、合并症、分娩方式及围生儿结局情况。结果观察组妊娠期高血压疾病(HDCP)发生率显著低于对照组,胎盘粘连、合并子宫肌瘤发生率均显著高于对照组,巨大儿发生率显著高于对照组,差异均有统计学意义(均P<0.05)。两组产妇妊娠期糖尿病(GDM)、妊娠期肝内胆汁淤积症(ICP)、胎盘早破、羊水量异常、前置胎盘、胎盘早剥、产后出血、分娩方式、早产、胎儿生长受限、新生儿窒息、围生儿死亡情况比较,差异均无统计学意义(均P>0.05)。结论相比高龄初产妇,高龄经产妇HDCP发生率明显降低,但其胎盘粘连、合并子宫肌瘤风险显著增大,巨大儿发生率高,需加强高龄孕产妇(特别是经产妇)的孕期管理。

Objective To compare pregnancy complications and pregnancy outcomes between elderly multiparous women and primiparous women. Methods From January 2010 to August 2017,715 elderly pregnant women who were hospitalized and delivered in Nuclear Industry 416 Hospital were selected and divided into observation group（multiparous women） and control group（primiparous women） according to the history of delivery. Pregnancy complications,complications,delivery modes,and perinatal outcomes were compared between the two groups. Results The incidence rate of hypertensive disorder complicating pregnancy（HDCP） in observation group was statistically significantly lower than that in control group,the incidence rates of placental adhesion,and uterine fibroids in observation group were statistically significantly higher than those in control group,the incidence rate of macrosomia in observation group was statistically significantly higher than that in control group（P〈0. 05）. There was no statistically significant difference in gestational diabetes mellitus（GDM）,intrahepatic cholestasis of pregnancy（ICP）,premature rupture of fetal membranes,amniotic fluid volume disorder,placenta previa,placental abruption,postpartum hemorrhage,delivery modes,premature delivery,fetal growth restriction,neonatal asphyxia,and perinatal death between the two groups（all P〈0. 05）. Conclusion Compared with elderly primiparous women,the incidence rate of HDCP is significantly lower in elderly multiparous women,however,the risks of placental adhesion and uterine fibroids are significantly higher,and the incidence rate of macrosomia is higher in elderly multiparous women. Therefore,pregnancy management of elderly pregnant women（especially multiparous women） needs to be strengthened.