不同年龄段高龄妊娠妇女的母婴结局研究

Maternal and fetal outcomes of aged women at different age

目的探讨不同年龄段高龄孕产妇的临床症状及其对应的母婴结局。方法选取2016年5月至2017年5月在温州市中心医院住院分娩的126例高龄孕产妇,按照孕妇分娩年龄的差异将35~39岁设为高龄1组(62例),≥40岁设为高龄2组(64例),选取同时间段在我院住院分娩的56例非高龄孕产妇为对照组,比较三组间孕期并发症及母婴结局。结果三组间妊娠期高血压、妊娠期糖尿病、早产发生率比较有显著性差异(χ~2值分别为6.054、6.125、6.534,均P<0.05),其发病率随着年龄的增加而增加,三组间前置胎盘、胎膜早破发生率比较无显著性差异(χ~2值分别为0.790、0.315,均P>0.05)。三组间剖宫产术率、产后出血发生率比较有显著性差异(χ~2值分别为23.219、6.573,均P<0.05),其发生率亦随着年龄的增加而增加,三组间手术助娩率比较无显著性差异(χ~2=2.257,P>0.05)。三组间巨大儿、新生儿转NICU发生率比较有显著性差异(χ~2值分别为6.565、6.299,均P<0.05),低出生体质量儿、新生儿窒息发生率比较无显著性差异(χ~2=0.790,P>0.05)。结论高龄孕产妇母婴不良结局显著增加,特别是高于40岁者,临床上应加强围产期保健,预防不良妊娠结局的发生。

Objective To investigate the clinical symptoms and maternal and fetal outcomes of aged women at different age.Methods A total of 126 aged women who delivered in Central Hospital of Wenzhou City from May 2016 to May 2017 were selected.According to the difference in age of delivery,they were divided into aged group 1（35 to 39 years old,62 cases）and aged group 2（40 years and older,64 cases）.Fifty-six normal maternity delivering in the hospital during the same period were selected as control group.Pregnancy complications and maternal and fetal outcomes were compared among three groups.Results There were significant differences in the incidence of gestational hypertension,gestational diabetes mellitus and preterm birth among three groups（χ~2 value was 6.054,6.125 and 6.534,respectively,all P〈0.05）,and the incidence increased with age.There was no significant difference in the incidence of placenta previa and premature rupture of membranes among three groups（χ~2 value was0.790 and 0.315,respectively,both P〈0.05）.There was significant difference in the incidence of cesarean section births and postpartum hemorrhage among three groups（χ~2 value was 23.219 and 6.573,respectively,both P〈0.05）and its incidence increased with age.There was no significant difference in the incidence of surgical delivery rate（χ~2=2.257,P〈0.05）.There was significant difference in the incidence of macrosomia and neonatal NICU among three groups（χ~2 value was 6.565 and 6.299,respectively,both P〈0.05）,but there was no significant difference in incidence of low birth weight infants and neonatal asphyxia among three groups（χ~2=0.790,P〈0.05）.Conclusion The adverse maternal and fetal outcomes of aged women have increased significantly,especially for those over 40 years old.Perioperative health care should be strengthened to prevent adverse pregnancy outcomes.