高龄产妇围产期妊娠结局观察

Observation of pregnancy outcomes of elderly parturient

目的:探讨≥35岁的高龄产妇所产新生儿的出生缺陷及并发症情况。方法:将1150例在2015年1月至2017年1月出生的新生儿根据产妇的年龄分为两组,其中550例年龄≥35岁产妇所产的新生儿作为高龄组,600例年龄<35岁产妇所产的新生儿作为适龄组。比较两组产妇围产期情况,新生儿一般情况,先天缺陷及生后并发症等情况,并通过logistic回归分析研究产妇高龄对新生儿出生缺陷及并发症发生情况的影响。结果:高龄组的剖宫产率、试管婴儿率及孕妇妊娠期糖尿病、妊娠期高血压、胎儿宫内窘迫发生率均显著高于适龄组,其差异具有统计学意义(均P<0.01);两组新生儿性别比例,身长,头围及出生体重的差异均无统计学意义(P>0.05),但适龄组新生儿的复苏抢救率显著低于高龄组,其差异具有统计学意义(P<0.01);高龄组新生儿的唇腭裂发生率高于适龄组,但骨骼畸形率低于高龄组,其差异具有统计学意义(P<0.05);两组新生儿生后出现感染、呼吸窘迫、高胆红素血症、贫血、支气管肺发育不良、颅内出血、视网膜病变,内分泌紊乱等情况的差异无统计学意义(P>0.05);单因素logistic回归分析显示,产妇高龄是胎儿发生宫内窘迫和新生儿复苏抢救的危险因素,但其是降低早产儿视网膜病变和贫血发生率的保护性因素。结论:相对于适龄产妇,高龄产妇妊娠期并发症发生率增加,且其所产新生儿唇裂发生率增加,但骨骼畸形发生率下降;产妇高龄会提高胎儿宫内窘迫、复苏抢救的风险,降低早产儿视网膜病变和贫血发生风险。

Objective： To study the effect of elderly parturient on birth defects and complications of neonates. Methods： 1150 neonates who were born from January 2015 to January 2017 were divided into two groups,according to the maternal age. 550 neonates whose mother were more than 35 years old were selected as advanced age group,and 600 neonates whose mother were less than 35 years old were enrolled as right age group. The incidence of perinatal complications,neonatalcomplications and birth defects of the two groups were compared. Results： The cesarean section rate,test-tube baby rate,gestational diabetes rate,gestational hypertension rate,fetal distress incidence of advanced age group were significantly higher than those of right age group（ P〈0. 01）. The differences between the two groups in the aspect of neonate sex ratio,body length,head circumference and birth weight were not statistically significant（ all P〉0. 05）,but neonatal resuscitation rate of advanced age group was obviously higher than that of right age group（ P〈0. 01）. The cleft lip and palate rate of advanced age group was more than that of right age group,but bone deformity rate was lower than that of right age group（ P〈0. 05）. The differences of occurrence rates of neonatal infections,respiratory distress,hyperbilirubinemia,anemia,bronchial pulmonary hypoplasia,intracranial hemorrhage,retinopathy and endocrine disorders between two groups were not statistically significant（ P〉0. 05）. Single factor logistic regression analysis showed that maternal age was the risk factor for fetal intrauterine distress and neonatal resuscitation,but it was the protective factor for premature retinopathy and anemia incidence. Conclusions： Compared with right-agedparturient,perinatal complications of advanced-agedparturient increases,and cleft lip and plate rate of neonates increases,but the bone deformity rate declines. Advanced maternal age can raise the risk of fetal distress,neonatal resuscitation,and reduce the risk of premature retinopathy and anemia of neonates.