高龄产妇妊娠期并发症及母婴结局分析

Analysis of pregnancy complications and maternal and infant outcomes in advanced maternal age

目的探讨高龄初产妇及经产妇妊娠期并发症及妊娠结局。方法回顾性分析2012年3月至2016年10月在山西医科大学第一医院住院分娩的10248例孕产妇病历资料,高龄产妇组1460例,适龄产妇组8788例,比较两组产妇的妊娠期并发症及母婴结局。同时按照初产妇、经产妇进行分层分析,比较高龄对初产妇及经产妇的不同影响。结果高龄组发生妊娠期糖尿病、妊娠期高血压疾病、前置胎盘、产后大出血、剖宫产、巨大儿、早产的发生风险是适龄产妇的1.485倍、1.320倍、1.409倍、1.642倍、1.670倍、1.299倍、1.440倍和1.233倍。按照初产妇和经产妇进行分层分析,初产妇高龄组发生妊娠期糖尿病、前置胎盘、胎盘早剥、产后大出血、剖宫产和早产的发生风险是适龄产妇的2.754倍、1.436倍、2.309倍、2.728倍、1.993倍和1.233倍。经产妇高龄组发生妊娠期糖尿病、妊娠期高血压疾病、前置胎盘、产后大出血、剖宫产、巨大儿和早产的发生风险是适龄产妇的1.356倍、1.326倍、1.452倍、1.505倍、1.571倍、1.351倍和1.266倍。结论高龄产妇妊娠期并发症及母婴不良结局的发生风险高于适龄妊娠产妇,高龄初产妇较适龄初产妇更容易发生胎盘早剥,高龄经产妇早产的发生风险较高。

Objective To explore the pregnancy complications and pregnancy outcomes of the elderly primipara and postpartum women.Methods A retrospective cohort study was carried out from March 2012 to October 2016 in the First Hospital of Shanxi Medical University.The advanced maternal age group was collected among a sample of 1460 pregnant women.The maternal age group was 8788 cases.Compared with pregnancy complications and maternal and infant outcomes between the two groups.At the same time,a stratified analysis was performed according to the primiparas and postpatum women,and compared the different effects of advanced age on primipara and postpartum women.Results The general risks of gestational diabetes,hypertensive disorder complicating pregnancy(HDCP),placenta previa,major postpartum hemorrhage,cesarean section,giant child,and preterm birth of advanced maternal age group was 1.485,1.320,1.409,1.642,1.670,1.299,1.440 and 1.233 times higher than the control group respectively.Stratified analysis by primipara and postpartum wowen,the general risks of gestational diabetes,placenta previa,placental abruption,postpartum hemorrhage,cesarean section and preterm birth of senior primipara group was 2.754,1.436,2.309,2.728,1.993 and 1.233 times higher than the control group respectively.The general risks of gestational diabetes,HDCP,placenta previa,postpartum hemorrhage,cesarean section,babies and preterm birth of maternity group was 1.356,1.326,1.452,1.505,1.571,1.351 and 1.266 times higher than the control group respectively.Conclusion The risk of pregnancy complications and adverse mother-infant outcomes in older primipara is higher than that in women of right age.Older primipara are more likely to have placental abruption than primipara of right age,and the risk of premature delivery is higher in elderly women.