足月妊娠产妇不良妊娠结局的影响因素分析

Analysis of influencing factors for adverse pregnancy outcome in pregnant women with full-term pregnancy

目的探讨足月妊娠产妇发生不良妊娠结局的相关影响因素。方法回顾性分析2017年3月-2019年8月期间在该院分娩的433例足月妊娠产妇的临床资料,依据其妊娠结局将入选者分为不良妊娠结局组(79例)与正常妊娠结局组(354例)。记录两组一般资料,分析足月妊娠产妇不良妊娠结局发生的相关影响因素。结果 433例足月妊娠产妇中共有79例(18. 24%)足月妊娠产妇发生不良妊娠结局,其中羊水污染占比较高(35. 44%),产后出血次之(25. 32%);两组产妇身高、体质量、文化程度、居住环境、孕周、孕次、产次、流产次数、胎位、羊水偏少、瘢痕子宫占比对比,差异均无统计学意义(均P>0. 05);不良妊娠结局组产妇年龄(≥30岁)、阴道分娩、妊娠期糖尿病、胎膜早破、前置胎盘、妊娠合并心脏病、妊娠期高血压疾病、妊娠合并甲状腺疾病、妊娠期合并贫血占比均高于正常妊娠结局组(P<0. 05);本研究经Logistic回归分析发现,年龄(≥35岁)、妊娠期糖尿病、胎膜早破、妊娠期高血压疾病为导致足月妊娠产妇不良妊娠结局发生的独立危险因素(均P=0. 000)。结论年龄(≥35岁)、妊娠期糖尿病、胎膜早破、妊娠期高血压疾病等均是造成足月妊娠产妇不良妊娠结局发生的影响因素,临床可通过指导孕产妇遵循健康的生活方式,合理制定其膳食营养结构,控制孕产妇血糖、血压等方式,降低妊娠风险。

Objective To investigate the influencing factors for adverse pregnancy outcome in pregnant women with full-term pregnancy. Methods The clinical data of 433 full-term pregnant women who delivered in the hospital from March 2017 to August 2019 were retrospectively analyzed. All selected cases were divided into adverse pregnancy outcome group( 79 cases) and normal pregnancy outcome group( 354 cases) according to the pregnancy outcome. The general data of two groups were recorded. The influencing factors for adverse pregnancy outcome of full-term pregnant women were analyzed. Results A total of 79 cases( 18. 24%) of adverse pregnancy outcome were detected in 433 full-term pregnant women,and the proportion of amniotic fluid pollution was the highest( 35. 44%),followed by postpartum hemorrhage( 25. 32%);There was no statistical difference in the height,weight,educational level,living environment,gestational weeks,gravidity,parity,abortion times,fetal position,oligohydramnios,scarred uterus between two groups( P>0. 05);The proportion of maternal age( ≥30 years old),vaginal delivery,gestational diabetes mellitus,premature rupture of membranes,placenta previa,pregnancy associated with cardiac disease,gestational hypertension,pregnancy with thyroid disease,pregnancy with anemia in adverse pregnancy outcome group was higher than that in normal pregnancy outcome group( P < 0. 05);Logistic regression analysis showed that the age( ≥30 years old),gestational diabetes mellitus,premature rupture of membranes,gestational hypertension were independent risk factors for adverse pregnancy outcome of full-term pregnant women( OR = 5. 338,6. 622,4. 968,5. 362,P = 0. 000). Conclusion The age( ≥30 years old),gestational diabetes mellitus,premature rupture of membranes,gestational hypertension are influencing factors for adverse pregnancy outcome of full-term pregnant women. Clinically,healthy lifestyle and rational dietary and nutritional structure for pregnant women can control maternal blood glucose and blood pressure,thus reducing the risks of pregnancy.