生育政策调整后医院经产妇生育特征及妊娠结局分析

Analysis of characteristics and pregnancy outcomes of multipara after adjusting fertility policy

目的:探讨二孩政策实施后医院经产妇的生育特征及妊娠分娩结局。方法:收集2016年11月1日—2016年12月31日在北京市海淀区3家医院住院分娩的2335例产妇资料。根据产次分为初产妇和经产妇,对两组产妇相关资料进行分析。结果:2335例产妇中,初产妇1465例(62.7%),经产妇870例(37.3%);≥35岁的高龄初产妇占15.6%,≥35岁的高龄经产妇占55.7%。经产妇妊娠≥3次、孕前超重和肥胖、瘢痕子宫的比例明显高于初产妇(P<0.05)。在校正年龄、职业因素后,经产妇胎盘植入、剖宫产及巨大儿的发生风险分别是初产妇的2.52倍、1.29倍及1.93倍,差异均有统计学意义(P<0.05)。结论:全面两孩政策实施后,生育二胎的高龄、高危经产妇明显增加,不良妊娠结局的发生风险也随之上升。应加强对经产妇的围产保健管理,促进母婴健康。

Objective：To investigate the reproduction features and pregnancy outcomes of multipara in Beijing after the two-child policy implementation.Methods：From November 1 to December 31 in 2016,clinical data of 2335 women who had come to 3 hospitals in Haidian district of Beijing for labor were collected.According to maternal parity,all included women were divided into primipara group or multipara group.The data of women in the two groups were analyzed to explore the maternal reproduction features and pregnancy outcomes of multipara after adjusting fertility policy.Results：Among the 2335 women,1465（62.7%）were primipara,and 870（37.3%）were multipara.The proportion of the maternal aged equal to or more than 35 years was 15.6% in primipara group and 55.7% in multipara group.Compared to primipara group,the proportion of maternal gravidity equal to or more than 3 times,the rate of pre-pregnancy overweight and obesity,and scared uterus in multipara group were significant higher（P〈0.05）.After adjusted age and occupation factors,the rate of placenta accreta,cesarean section and macrosomia in multipara group were 2.52 times,1.29 times,and 1.93 times of those in primipara group,respectively,which had statistical significant（P〈0.05）.Conclusion：After the implementation of the comprehensive two-child policy,the proportion of multipara with high-risk or elder multipara was increased significantly,and the occurrence of adverse pregnancy outcomes also increased.Maternal health management should be strengthened to promote maternal and child health.