稽留流产的现况及影响因素分析

Analysis of current status and influencing factors of missed abortion

目的了解首都医科大学附属北京妇产医院计划生育科就诊患者稽留流产的发生率及其影响因素。方法对2017~2019年来首都医科大学附属北京妇产医院计划生育科就诊的早孕要求流产或稽留流产要求清宫手术的3910名女性进行调查。登记患者的一般情况(年龄、孕产次、学历、户籍所在地、婚姻状况、职业、体重、剖宫产次数),比较人工流产患者和稽留流产患者之间的差异。结果3910名患者中,稽留流产患者734名,占18.77%。相对于早孕人工流产患者,稽留流产患者的年龄更大[(32.89±5.24)vs.(29.30±5.91)岁,P<0.05],孕次更多、产次更少(P<0.05),体重更重[(59.32±9.26)kg vs.(55.65±8.23)kg,P<0.05],受教育程度更高(P<0.05),已婚者占比更高(95.5%vs.50.7%,P<0.05),京籍占比更高(44.4%vs.32.3%,P<0.05),而在职者占比、剖宫产次数均无统计学差异(P>0.05)。Logistics多因素回归分析表明,随着年龄、体重、学历的增长,稽留流产发生率增加(P<0.05);而随着分娩次数的增多,稽留流产率降低(P<0.05);已婚或离异也是稽留流产的危险因素(P<0.05),而职业和户籍所在地与稽留流产无明显相关性(P>0.05)。结论年龄、体重、高学历、已婚或离异为稽留流产的危险因素,产次为发生稽留流产的保护因素。为了降低稽留流产发生率,建议女性要尽早生育,肥胖女性要减重;而学历与年龄和产次对稽留流产的影响有相关性,但不能认为高学历为稽留流产的独立危险因素。

Objective:To investigate the incidence of missed abortion and its influencing factors in Beijing Obstetrics and Gynecology Hospital,Capital Medical University.Methods:A total of 3910 pregnancy women who requested abortion or curettage due to missed abortion in the Beijing Obstetrics and Gynecology Hospital,Capital Medical University from 2017 to 2019 were investigated.General information including age,gravidity&parity,education,domicile location,marital status,occupation,weight and cesarean times were surveyed.The difference was compared between induced abortion women and missed abortion women.Results:Among 3910 patients,734(18.77%)were missed abortion.Compared with early pregnancy abortion patients,the missed abortion patients were older[(32.89±5.24)vs.(29.30±5.91)years,P<0.05],more gravidity,fewer parity(P<0.05),heavier weight[(59.32±9.26)vs.(55.65±8.23)kg,P<0.05],higher education level(P<0.05),higher percentage of married persons(95.5%vs.50.7%,P<0.05),higher proportion of Beijing household registration(44.4%vs.32.3%,P<0.05),while the proportion of incumbents and the number of cesarean sections was not significantly different(P>0.05).Logistic regression analysis showed that the incidence of missed abortion increased along with the increase of age,weight and education level(P<0.05).With the increase of parity,the incidence of missed abortion decreased(P<0.05).The married and divorce were the risk factors of missed abortion(P<0.05),while occupation and location of household register had no significant correlation with missed abortion(P>0.05).Conclusions:Age,weight,high education,married or divorced were the risk factors of missed abortion.The parity was the protective factor of missed abortion.In order to reduce the incidence of missed abortion,it is suggested that women should give birth as soon as possible,and obese women need to lose weight.The influence of education,age and parity were related with missed abortion,but higher education is not considered as an independent risk factor for missed abortion.