广东省育龄妇女自然流产发生情况及其影响因素分析

Epidemiology of spontaneous abortion and its risk factors in Guangdong province

目的探索广东省育龄妇女自然流产的发生情况及其影响因素。方法选取广东省2017年参与国家免费孕前健康检查的20~53岁已婚育龄妇女为研究对象,共计104300例,妇女平均年龄(27.6±4.5)岁,其中农村户籍81185例,城市户籍23115例。采用卡方检验与Logistic回归模型分析孕前高龄、常见生殖道感染、常见性病和TORCH感染等不良风险因素与自然流产的关系。结果共随访104300例育龄妇女,总妊娠结局104300例,自然流产2363例,总自然流产发生率为2.3%,其中城市自然流产发生率为3.9%,农村自然流产的发生率为1.8%。高龄(OR=2.76,95%CI:2.50~3.06)、不良妊娠史(OR=1.77,95%CI:1.61~1.94)、不良饮食习惯(OR=1.43,95%CI:1.16~1.94)、不良生活习惯(OR=1.70,95%CI:1.24~2.32)、高血压(OR=1.63,95%CI:1.25~22.11),常见生殖道感染(OR=2.44,95%CI:2.20~2.70)均为自然流产的危险因素。未发现孕前感染淋病、沙眼支原体、梅毒和TORCH与自然流产有显著关联。结论广东省参与孕前优生项目育龄妇女的自然流产率处于较低水平,孕前检查与干预有利于减少自然流产的发生,应加强孕前优生指导。

Objective To explore the prevalence rate of spontaneous abortion and its risk factors in Guangdong Province.Methods In 2017,women aged from 20 to 53 years(104300,city:23115,Countryside:81185)who participated in the national pre-pregnancy health in Guangdong province were included in the study.Among 104300 included women(average age:[27.6±4.5]years),23115 were from city and 81185 from countryside.Chi-square test and logistic regression model were used to explore the relationship between spontaneous abortion and pre-pregnancy adverse factors including advanced age,reproductive tract infections,venereal disease,TORCH infection,etc.Results Among 104300 pregnant women,2363 had spontaneous abortions,resulting in an overall rate of spontaneous abortion of 2.3%(2363/104300).The spontaneous abortion rate was 3.9%(898/23115)for women from city,and 1.8%(1465/81185)for those from countryside.Women with advanced age(OR=2.76,95%CI:2.50-3.06),adverse pregnancy history(OR=1.77,95%CI:1.61-1.94),unhealthy dietary habits(OR=1.43,95%CI:1.16-1.94),unhealthy lifestyle(OR=1.70,95%CI:1.24-2.32),hypertension(OR=1.63,95%CI:1.25-22.11),and common reproductive tract infection(OR=2.44,95%CI:2.20-2.70)had higher risk of spontaneous abortion.We did not found significant association of spontaneous abortion with pre-pregnancy gonorrhea,trachomatis,syphilis,or TORCH infection.Conclusion The spontaneous abortion rate for women participated in the national pre-pregnancy health in Guangdong province is at a low level.Pre-pregnancy examination and intervention are benefit for reducing the occurrence of spontaneous abortion.There is a need to strengthen pre-pregnancy guidance.