高龄经产妇与适龄经产妇临床特点及妊娠结局比较

Comparison of the clinical characteristics and pregnancy outcome between the senile and right-age multipara

目的比较高龄经产妇与适龄经产妇临床特点及妊娠结局。方法选择2016年1月至2017年1月于洛阳市妇女儿童医疗保健中心分娩的高龄经产妇125例(高龄组)和适龄经产妇125例(适龄组),对2组产妇的一般临床资料、并发症及妊娠结局进行比较。结果高龄组大学本科及以上文化程度、28~36孕周分娩及有剖宫产史者所占比例显著高于适龄组,与前次妊娠间隔时间显著长于适龄组(P<0.05);但2组流产史、辅助生殖技术受孕史比较差异无统计学意义(P>0.05)。高龄组妊娠高血压、妊娠期糖尿病、前置胎盘以及胎盘粘连发生率显著高于适龄组(P<0.05),2组胎盘早剥、胎膜早破及产后出血发生率比较差异无统计学意义(P>0.05)。高龄组新生儿出生体质量、新生儿Apgar评分显著低于适龄组(P<0.05),高龄组巨大儿、早产发生率显著高于适龄组(P<0.05),2组新生儿窒息、胎儿畸形及死胎发生率比较差异无统计学意义(P>0.05)。结论高龄经产妇早产及妊娠并发症发生率较高,围生儿结局不良的风险增大,应加强高龄经孕妇的产前保健工作,以减低妊娠期并发症,改善妊娠结局。

Objective To compare the clinical characteristics and pregnancy outcome between the senile and right-age multipara. Methods A total of 125 senile multipara（ senile group） and 125 right-age multipara（ right-age group） were selected from January 2016 to January 2017 in Luoyang Women and Children’ s Health Care Center. The general clinical data,pregnancy complications and pregnancy outcome of the multipara were compared between the two groups. Results The percentages of the multipara with educational level above the undergraduate,parturition in 28-36 gestational weeks and cesarean section history in the senile group were significantly higher than those in the right-age group; and the pregnancy interval time in the senile group was significantly shorter than that in the right-age group（ P 〈 0. 05）. There was no significant difference in the abortion history and the pregnancy history of assisted reproductive technology between the two groups（ P 〉 0. 05）. The incidences of gestational hypertension,gestational diabetes mellitus,placenta praevia and placental adherence in the senile group were significantly higher than those in the right-age group（ P 〈 0. 05）. There was no significant difference in the incidences of placental abruption,premature rupture of membranes and postpartum hemorrhage between the two groups（ P 〉 0. 05）. The birth weight and Apgar score of newborns in the senile group were significantly lower than those in the right-age group（ P 〈0. 05）. The incidences of macrosomia and preterm labor in the senile group were significantly higher than those in the right-age group（ P 〈 0. 05）. There was no significant difference in the incidences of asphyxia of newborn,fetal anomaly and fetal death between the two groups（ P 〉 0. 05）. Conclusions The incidences of premature delivery and pregnancy complications are higher in senile multipara,and the risk of cacoethic perinatal outcome is increased. Therefore,the prenatal care for senile multipara should be strengthened to reduce pregnancy complications and improve pregnancy outcome.