高龄产妇并发妊娠期高血压疾病对围生期结局的影响

Effect of the Perinatal Outcome of Elderly Gravidas with Gestational Hypertension and Their Neonate

目的 :探讨妊娠期高血压疾病对高龄产妇的围生期结局的影响。方法:选取我院2015年1月~2016年1月一共收治的259名孕妇,根据年龄分组,67例的高龄孕妇(>35岁)并发妊娠期高血压疾病作为观察组,192例同期适宜生育年龄的孕妇(<35岁)并发妊娠期高血压疾病孕妇作为对照组,比较观察组和对照组胎儿的围生期结局和胎儿的状况。结果:观察组的孕周(28.3±4.2)少于对照组的孕周(32.4±3.6),差异有统计学意义(P<0.05);观察组的重度子痫前期(34.3%)和子痫(17.9%)发生率高于对照组的重度子痫前期(27.1%)和子娴(3.6%)发生率,差异具有统计学意义(P<0.05);观察组的妊娠期高血压心脏病(3.0%)、HELLP综合征(1.5%)、胎膜早破(14.9%)、早产(10.4%)的发生率高于对照组的发生率(分别为0.7%、1.1%、5.7%、4.3%),差异具有统计学意义(P<0.05),观察组的胎盘早剥、产后出血的发生率高于对照组,但差异不具有统计学意义(P>0.05);观察组的胎儿窘迫发生率(13.4%)高于对照组的胎儿窘迫发生率(5.7%),差异具有统计学意义(P<0.05),观察组的胎儿生长受限、新生儿窒息、围产儿死亡、新生儿畸形的发生率高于对照组,但差异不具有统计学意义(P>0.05)。结论:高龄产妇并发妊娠期高血压病的危害程度高于同期非高龄产妇,应提倡适龄婚育,必要时终止妊娠,保护母儿的生命与健康。

Objective:To investigate the perinatal outcomes of elderly gravidas with gestational hypertension and their neonate.Methods:In total,259pregnant women were admitted and treated in our hospital from January2015to January2016.They were divided into test group and control group by age,61elderly gravidas with gestational hypertension(over35-year-old)in test group,and192child-bearing gravidas with gestational hypertension(under35-year-old)in control group.The perinatal outcomes of gravidas with gestational hypertension and their neonate were compared in two groups.Results:(1)The gestational age in test group(28.3±4.2)was significantly shorter than that in control group(32.4±3.6)(P<0.05).(2)The severe preeclampsia and eclampsia in test group were significantly higher than those in control group[(34.3%vs.27.1%)and[(17.9%)vs.(3.6%)],respectively(P<0.05).(3)The hypertensive heart disease in pregnancy,HELLP syndrome,premature rupture,premature birth in test,were significantly higher than those in control group[(3.0%vs.0.7%)],[(1.5%vs.1.1%)],[(14.9%vs.5.7%)],[(10.4%vs.4.3%)],respectively(P<0.05).(4)The incidence of placental abruption and postpartum haemorrhage in test group were higher than those in control group,with statistically non-significant differences(P>0.05).(5)The incidence of fetal distress in test group(13.4%)was significantly higher than that in control group(5.7%)(P<0.05).(6)The incidence of fetal growth retardation,neonatal asphyxia,perinatal mortality,neonatal congenital malformation in test group,were higher than those in control group,with statistically non-significant differences(P>0.05).Conclusions:Gestational hypertension is more harmful for elderly pregnancy,should advocate women to conceive in reproductive age,or to terminate pregnancy when necessary in order to preserve mother’s and offspring’s life and healthy.