早产发生率及高危因素及对围产结局的影响

Study on the incidence of preterm birth and risk factors and their influence on perinatal outcomes

目的探讨该地早产儿的发生率,分析早产的高危因素,并总结早产对母婴围产结局的影响,为早产病因研究以及预防提供科学参考。方法回顾分析某医院围产门诊2018年1月至12月检查的符合纳入标准的140例早产产妇(早产组)以及1 634例正常分娩产妇(对照组)的临床资料,观察早产产妇与正常产妇的围产结局,采用单因素分析以及多因素logistics逐步回归分析早产的高危因素。结果早产发生率为7.89%(140/1774),早产产妇与正常产妇的分娩方式比较,差异均无统计学意义(P>0.05);早产组早产儿的出生缺陷、围产儿死亡以及新生儿窒息发生率均高于正常对照组,差异均有统计学意义(P<0.05);通过单因素χ^2检验分析得出,有人工流产史、妊娠期高血压、体力劳动者、前置胎盘、胎膜早破、臀位是早产发生的危险因素,差异有统计学意义(P<0.05);通过多因素logistics逐步回归分析得出,妊娠高血压(OR=29.702,P<0.05)、体力劳动者(OR=2.582,P<0.05)、前置胎盘(OR=42.229,P<0.05)、臀位(OR=5.448,P<0.05)、胎膜早破(OR=5.783,P<0.05)是早产发生的高危因素。结论早产的高危因素较为复杂,早产会对母婴围产结局产生的一定的影响,临床应采取积极的综合防治措施以减少早产发生。

Objective To investigate the incidence of preterm birth,analyze the risk factors of preterm birth,and summarize the influence of preterm birth on perinatal outcomes,so as to provide scientific reference for etiology research and prevention of preterm birth.Methods Retrospective analysis of the clinical data of 140 preterm mothers(preterm group)and 1634 normal mothers(control group)who met the inclusion criteria and were examined in the obstetrics and gynecology clinic of our hospital from January to December,2018,to observe the perinatal outcomes of preterm and normal mothers,single factor analysis and multi-factor Logistics stepwise regression were used to analyze the risk factors of premature delivery.Results The preterm birth rate was 7.89%(140/1774),there was no significant difference in the delivery mode between preterm and normal mothers(P>0.05);The incidence of birth defects,perinatal death and neonatal asphyxia of premature infants in the preterm group was higher than that in the normal control group,with statistically significant differences(P<0.05);By single factor 2 test analysis,history of abortion,gestational hypertension,manual workers,placenta previa,premature rupture of membranes,breech is a risk factor for preterm delivery occurs,the difference was statistically significant(P<0.05);According to multi-factor Logistics stepwise regression analysis,gestational hypertension(OR=29.702,P<0.05),manual labor(OR=2.582,P<0.05),placenta previa(OR=42.229,P<0.05),breech position(OR=5.448,P<0.05),and premature rupture of membranes(OR=5.783,P<0.05)are high risk factors for premature delivery.Conclusion The high risk factors of preterm birth are complex,and preterm birth will affect the perinatal outcomes of mothers and infants to some extent.