成都市胚胎停育现况及影响因素研究

Study on current status and risk factors for embryo loss

目的 了解成都市早孕胚胎停育的现状,分析成都市胚胎停止发育相关危险因素,为降低胚胎停育发生率提出可行性建议。方法 选取家具制造加工集中的两个区县,采取机会性抽样的方式抽取226名胚胎停育妇女为研究对象,根据研究对象的年龄、BMI和城乡情况选择226名正常分娩妇女为对照组,分析早孕胚胎停育的影响因素。结果 2014-2016年,全市胚胎停育率从4.34%升高到5.60%,远高于同期出生缺陷发生率。月经规律(OR=0.438,95%CI:0.230~0.830)和接受孕期保健为胚胎停育的保护性因素(OR=0.179,95%CI:0.110~0.291),本次妊娠曾服用紧急避孕药(OR=4.687,95%CI:1.533~14.334),孕期被动吸烟(OR=1.593,95%CI:1.146~2.215),半年内新购家具(OR=2.572,95%CI:1.302~5.084)为胚胎停育的危险因素。结论 胚胎发育早期不仅受到母体内环境因素的影响,同时也受到外环境影响。改善孕妇生活环境和工作环境,尽早接受医疗保健服务对降低早孕期胚胎停育发生率有利。

Objectives To understand the epidemic of embryo loss,and to analyze the risk factors for embryo loss,so as to provide scientific suggestions for decreasing the rate of embryo loss.Methods Totally 226 women with embryo loss were enrolled in this study in two counties where furniture manufacturers were located.Meantime,226 normal delivered women were selected as control matched by age,body mass index(BMI)and address(urban or rural areas).The influencing factors of embryo loss in early pregnancy were analyzed.Results The embryo loss rate rose from 4.34%in 2014 to 5.60%in 2016,significantly higher than the birth defect rate at the same period.Multiple regression analysis showed that regular period(OR=0.438,95%CI:0.230-0.830),health care during pregnancy(OR=0.179,95%CI:0.110-0.291)were protective factors for embryo loss.Taking emergency contraception pill during this pregnancy(OR=4.687,95%CI:1.533-14.334),second-hand smoking(OR=1.593,95%CI:1.146-2.215),and purchasing new furniture over the past 6 months(OR=2.572,95%CI:1.302-5.084)were risk factors for embryo loss.Conclusions Embryo development in early pregnancy is influenced by both material and natural environment.Improving life and working environment during pregnancy and accepting health care services in early pregnancy are helpful to reduce embryo loss rate in early pregnancy.