云南省保山市孕产妇不良妊娠结局相关因素调查

The survey of the correlation between adverse pregnancy outcomes of women and their menstrual history and birth history in Baoshan city of Yunnan Province

目的:探讨孕产妇不良妊娠结局与月经史和生育史的相关性,为降低不良妊娠结局发生率提供指导。方法:运用回顾性队列研究方法,选取2010-2017年云南省保山市接受过国家免费孕前优生健康检查项目技术服务登记的妇女为研究对象,从其妊娠在医疗机构建卡时开始纳入随访队列并收集基线信息,随访至分娩结束,观察分娩结局。以是否为不良妊娠结局对相关因素进行检验和多因素COX回归分析。结果:共调查4285名孕产妇,其中不良妊娠结局发生率为15.0%。多因素COX回归分析结果显示:女方民族为其他少数民族(HR=1.813,95%CI:1.008,3.261),年龄≥34岁(HR=1.856,95%CI:1.043,3.301)和人工流产次数(HR=1.585,95%CI:1.118,2.247)是不良妊娠结局发生的危险因素(P<0.05)。结论:应重视孕产妇孕前及孕期保健宣传教育,健全妇幼健康保健体系。鼓励妇女适龄生育,了解生育史的相关科学知识,减少人工流产,以有效降低不良妊娠结局的发生。

Objective:To explore the correlation between the adverse pregnancy outcomes of women and their menstrual history and birth history,and to provide guidance for reducing adverse pregnancy outcomes.Methods:A retrospective cohort study method was conducted,and the women who had received the technical service registration of the national free pre pregnancy eugenic health checkup project in Baoshan City of Yunnan Province were select in this study from 2010 to 2017.The pregnant women were included into followed up cohort and their baseline information was collected from the time of these women registered.And they were followed up until to delivery,and their delivery outcomes were observed.The related factors were performed based on the adverse pregnancy outcomes by multivariate COX regression analysis.Results:A total of 4285 pregnant women were surveyed in this study,and the incidence of adverse pregnancy outcomes was 15.0%.Multivariate COX regression analysis showed that the female with ethnic minority(HR=1.813,95%CI:1.008,3.261),the female age≥34 years old(HR=1.856,95%CI:1.043,3.301),and the number of abortion(HR=1.585,95%CI:1.118,2.247)were the risk factors of adverse pregnancy outcomes(P<0.05).Conclusion:The education for women pre pregnancy and during pregnancy should be paid attention to,and the health care system for women and children should be strengthened.In order to effectively reduce the incidence of adverse pregnancy outcomes,the women should be encouraged to have children at the right age and be encouraged to understand the relevant scientific knowledge on reproductive history for reducing induced abortion number.