北京市通州区孕产妇妊娠特点及妊娠结局分析

Maternal pregnancy characteristics and outcomes in Tongzhou district of Beijing

目的探讨北京市通州区孕产妇妊娠特点及妊娠结局。方法选择2016年10月至2017年9月在通州区20家社区卫生服务中心管理的妊娠满28周及以上的孕产妇为研究对象,共计12 385例。以"产次"分为初产妇组与经产妇组,回顾分析两组孕产妇妊娠特点及妊娠结局。结果经产妇占比略低于初产妇,经产妇与初产妇在妊娠年龄≥35岁、受教育程度、工作状况、分娩机构的选择、有无高危因素等方面均存在差异(χ~2值分别为968.422、717.094、79.012、136.677、610.990,均P<0.001),经产妇的妊娠年龄、孕前体质量指数(BMI)均高于初产妇(t值分别为56.506、17.821,均P<0.001)。经产妇高危因素前五位顺位分别为瘢痕子宫、高龄(预产期≥35岁)、妊娠期糖尿病、贫血及甲状腺功能异常(χ~2值分别为3 913.663、1 082.269、37.944、16.138、31.133,均P<0.001),经产妇所生新生儿死胎死产、低出生体重的比例显著低于初产妇(χ~2值分别为5.258、11.429,均P<0.05)。结论经产妇具有高龄、学历较低、无工作、有高危因素的特征,剖宫产率较高。建议医疗机构针对孕产妇身份开展孕期指导,经产妇提供高危因素、孕期营养等保健知识;针对初产妇提供胎动计数、胎动异常等孕期指导。

Objective To explore the characteristics and outcomes of pregnant and lying-in women in Tongzhou district of Beijing.Methods During October 2016 to September 2017,a total of 12 385 pregnant women with 28 weeks of pregnancy were included in research,who were managed in 20 community health service centers in Tongzhou district.They were divided into primipara group and multipara group for retrospective analysis of their characteristics and outcomes.Results Proportion of multipara was slightly lower than that of primipara.There were differences in number of cases aged 35 or above,educational level,working status,choice of delivery place,presence of high-risk factors between primipara group and multipara group（χ~2 value was 968.422,717.094,79.012,136.677 and 610.990,respectively,all P0.001）.The reproductive age and pre-pregnancy BMI of multipara were higher than primipara（t value was 56.506 and 17.821,respectively,both P0.001）.The first five high-risk factors of multipara were scar uterus,advanced maternal age（age of expected delivery≥35 years）,gestational diabetes mellitus,anemia,and abnormal thyroid function（χ~2 value was 3 913.663,1 082.269,37.944,16.138 and 31.133,respectively,all P 0.001）.The rate of stillbirth and low birth weight of newborns in multipara group was significantly lower than that in primipara group（χ~2 value was 5.258 and 11.429,respectively,both P〈0.05）.Conclusion Multipara women have the characteristics of advanced age,low educational background,no occupation,and high-risk factors,and their cesarean section rate is higher.It is recommended that medical institutions conduct pregnancy guidance according to maternal condition,providing health care knowledge for multipara on high-risk factors and nutrition in gestational period and providing fetal movement count and abnormal fetal movement for primipara.