北京市妊娠危险因素及妊娠结局分析研究

Analysis and Research of Pregnancy Risk Factors and Pregnancy Outcomes in Beijing

目的分析自实行“全面二孩”政策以来妊娠危险因素、主要不良妊娠事件和妊娠结局的变化情况。方法将2014年1月~2018年12月在首都医科大学附属北京同仁医院分娩的孕妇以2017年1月1日为时间点分为“全面二孩”政策前组和“全面二孩”政策后组。在两组人群中采用数字表法各随机抽取1000例孕产妇资料,回顾性分析“全面二孩”政策前组和“全面二孩”政策后组孕产妇的临床病例资料,统计分析两组孕产妇的妊娠危险因素和妊娠结局。结果高龄(≥35岁)、妊娠期糖尿病、妊娠合并子宫瘢痕和妊娠合并子宫肌瘤等妊娠危险因素发生率后组较前组明显增高(P<0.05),妊娠合并巨大儿发生率后组比前组明显下降(P<0.05)。在不良事件发生上,后组主要不良事件发生率显著高于前组。其他次要不良妊娠结局中会阴裂伤发生率后组较前组明显升高(P<0.05);急性胎儿宫内窘迫的发生率后组较前组明显下降(P<0.05)。结论高龄(≥35岁)、妊娠期糖尿病、妊娠合并子宫瘢痕和妊娠合并子宫肌瘤等妊娠危险因素发生率显著升高。主要不良妊娠事件发生率的增高是由高龄孕产妇的增多导致。在临床工作中应注意妊娠主要危险因素的一级预防,提高对高龄产妇发生妊娠期糖尿病的警惕性。

Objective To analyze the changes of pregnancy risk factors,adverse pregnancy events and pregnancy outcomes since the implementation of the universal two-child policy.Methods Pregnant women who gave birth in Beijing tongren hospital affiliated to capital medical university from January 2014 to December 2018 were divided into a universal two-child policy first group and a universal two-child policy latter group at the time point of January 1,2017.Randomized digital table method was used to randomly select 1000 maternal data in the two groups.The clinical data of pregnant women from the two group were retrospectively analyzed,and pregnancy risk factors and pregnancy outcomes of the two groups were statistically analyzed.Results The incidence of pregnancy risk factors such as advanced age (≥35 years old),gestational diabetes mellitus,uterine scar and uterine fibroids was significantly higher in the latter group than in the former group ( P <0.05),and the incidence of macrosomia was significantly lower in the latter group than in the former group ( P <0.05).In terms of adverse events,the incidence of major adverse events in the latter group was significantly higher than that in the former group.The incidence of perineal laceration in other secondary adverse pregnancy outcomes was significantly higher in the latter group than in the former group ( P <0.05).The incidence of acute fetal distress was significantly lower in the latter group than in the former group ( P <0.05).Conclusion The incidence of pregnancy risk factors such as advanced age (≥35 years old),gestational diabetes mellitus,uterine scar and uterine fibroids was significantly increased.The increase in the incidence of major adverse pregnancy events is due to an increase in maternal age.In the clinical work,we should pay attention to the primary prevention of major pregnancy risk factors,and improve the vigilance of gestational diabetes in older women.