围孕期生活行为及环境危险因素与不良妊娠结局的关系研究

Study on the relationship between periconceptional lifestyle and environmental factors and adverse pregnancy outcomes

目的探索围孕期母体生活行为及环境危险因素暴露与不良妊娠结局的关系。方法回顾性纳入2016年5月至2017年2月西安交通大学第一附属医院妇产科收治且发生不良妊娠结局的孕妇54例作为病例组,另随机选取同期产检正常并怀有健康胎儿的孕妇237例作为对照组。通过问卷调查收集所有孕妇在围孕期的生活行为和环境因素暴露史,采用单因素及多因素Logistic回归模型分析围孕期母体生活行为及环境因素对不良妊娠结局发生风险的影响。结果对年龄、教育程度、居住地、孕前BMI、产次和不良妊娠史进行调整后,多因素Logistic回归分析显示,围孕期母体出现频繁的紧张及抑郁情绪是导致不良妊娠结局的独立危险因素(OR=4.13,95%CI:1.26~13.53,P<0.05)。且围孕期噪音暴露也会显著增加不良妊娠结局的发生风险(OR=2.88,95%CI:1.01~8.17,P<0.05)。结论围孕期母体频繁的紧张、抑郁情绪以及噪音暴露均可能增加不良妊娠结局的发生风险。故应加强对育龄妇女的健康教育以及心理干预,指导其养成健康的行为及生活方式,降低不良妊娠结局的发生风险。

Objective To explore the relationship between periconceptional lifestyle and environmental factors and adverse pregnancy outcome.Methods From May 2016 to February 2017,54 pregnant women with adverse pregnancy outcomes and admitted in the Obstetrics and Gynecology Department of the First Affiliated Hospital of Xi’an Jiaotong University were retrospectively included into the case group,and 237 pregnant women with normal prenatal examination and healthy fetus were selected as the control group at the same time.The life behavior and environmental factor exposure history of them during pregnancy were collected through questionnaire survey.Univariate and multivariate Logistic regression models were used to analyze the influence of periconceptional environment exposure and lifestyle factors on the risk of adverse pregnancy outcome.Results After adjusting for age,education,place of residence,pre-pregnancy BMI,number of births and history of adverse pregnancy,the results of multivariate Logistic regression analysis showed that frequent stress and depression during pregnancy was dependent risk factor for adverse pregnancy outcomes(OR=4.13,95%CI:1.26-13.53,P<0.05).And maternal exposure to noise during pregnancy also significantly increased the risk of adverse pregnancy outcomes(OR=2.88,95%CI:1.01-8.17,P<0.05).Conclusion Frequent stress and depression,and exposure to ambient noise might increase the risk of adverse pregnancy outcomes.Therefore,it is necessary to strengthen the health education and psychological intervention of women of childbearing age,and guide them to develop healthy behaviors and lifestyles,which is conducive to reduce the risk of adverse pregnancy outcomes.