染色体三体妊娠发生相关因素病例-对照研究

Case-control study on factors related to chromosome trisomic pregnancy

目的通过对比胎儿染色体正常孕妇与胎儿染色体核型为标准三体孕妇在妊娠方式、盆腔手术史、月经是否规律、正常生育次数、自然流产次数、人工流产次数、毒物接触史等方面是否存在差异,了解三体妊娠发生的高危因素。方法从2011年1月至2018年2月在内蒙古医科大学附属医院妇产科行羊水穿刺的1 098例患者中,选取标准三体妊娠孕妇77例作为研究组,为每位孕妇选择1名与其年龄相同,胎儿染色体正常的孕妇做对照组。通过条件逻辑回归分析,比较两组间是否在妊娠方式、盆腔手术史、月经是否规律、正常生育次数、自然流产次数、人工流产次数、毒物接触史方面存在差异。结果条件逻辑回归分析结果显示,月经不规律与三体妊娠发生存在关联(OR=5.596;95%CI 1.921-17.196,P=0.003);在三体妊娠组中,有盆腔手术史者的比例(11.7%)高于对照组(3.7%),但差异无统计学意义(P=0.057)。结论月经不规律是三体妊娠发生的高危因素,有盆腔手术史较无盆腔手术史易发生三体妊娠。

Objective To study the risk factors associated with trisomic pregnancy, we examined the differences between women with trisomic pregnancies and women with chromosomally normal pregnancies in terms of menstrual history, family history, history of pelvic surgery, assisted reproduction, and history of toxin exposure. Methods From January 2011 to February 2018, 1 098 patients underwent amniocentesis in the Obstetrics and Gynecology Department of the Affiliated Hospital of Inner Mongolia medical university. In 1 098 patients underwent amniocentesis, 77 trisomic pregnant women were selected as the study group. The 77 control group was selected for each pregnant woman of the same age with normal fetal chromosomes. Logistic regression analysis was conducted using statistical software. Results The results of conditional logistic regression analysis showed that there was an association between irregular menstruation and trisomic pregnancy(OR=5.596;95 % CI 1.921-17.196, P=0.003). The women with a history of pelvic surgery in the trisomic pregnancy group were significantly higher than those in the control group(11.7 % in the trisomic pregnancy group, 3.7 % in the control group,P=0.057). Conclusion Irregular menstruation is a high risk factor for trisomic pregnancy. Women with a history of pelvic surgery are more prone to trisomic pregnancy than those without a history of pelvic surgery.