高龄对胎儿生长受限的影响

The effect of advanced maternal age on fetal growth restriction

目的探讨高龄对胎儿生长受限(FGR)的影响以及分析FGR的危险因素。方法分析2 436例诊断为FGR孕妇的临床资料。按照年龄分为<35岁组(n=2 092)和≥35岁组(n=344)。分析比较两组孕产妇一般情况、妊娠合并症及并发症的发生情况以及母胎结局,探讨FGR相关危险因素。结果≥35岁组FGR发生率为9.40%,较<35岁组(1.17%)明显升高,差异有统计学意义(P<0.05)。妊娠合并慢性高血压、轻度子痫前期、重度子痫前期、妊娠期糖尿病、妊娠合并肾炎、羊水过多、剖宫产、早产、死胎在≥35岁高龄组显著增高(P<0.05)。多因素Logistic回归分析提示FGR的独立危险因素为年龄、妊娠期高血压疾病、妊娠合并肾炎、脐带异常、羊水异常(P<0.05)。结论年龄是FGR的高危因素之一,随着年龄的增加,发生FGR的风险增加。

Objective To explore the effects of advanced maternal age on fetal growth restriction （FGR） and analyze the risk factors of FGR. Methods The clinical data of 2 436 cases of FGR was analyzed retrospectively. According to age, they were divided into 〈35 years old group （n=2 092） and ≥35 years old group （n=344）. The general conditions of pregnant women, pregnancy complications and maternal fetal outcomes were analyzed and compared to explore the risk factors associated with FGR. Results The incidence of FGR in the≥35-year-old group （9.40%） was significantly higher than that in the 〈35-year-old group （1.17%） （P〈0.05）. Pregnancy with chronic hypertension, mi｜d pre-eclampsia, severe pre-eclampsia, gestational diabetes, pregnancy with nephritis, polyhydramnios, cesarean section and premature delivery, stillbirth rate was significantly increased in the elderly group （P〈O.05）. Multivariate logistic regression analysis indicated that the independent risk factors for fetal growth restriction were age, hypertensive disorder complicating pregnancy, pregnancy with nephritis, umbilical cord abnormalities, and amniotie fluid abnormalities （P〈O.05）. Conclusion Maternal age is one of the high risk factors for fetal growth restriction, and as the age increases, the risk of fetal growth restriction increases.