不同妊娠间隔时间对高龄单胎妊娠经产妇妊娠结局的影响

Effect of Different Gestational Interval on Pregnancy Outcome of Elderly Single Pregnancy

[目的]探讨不同妊娠间隔时间对高龄单胎妊娠经产妇妊娠结局的影响。[方法]回顾性分析2013年1月至2018年12月在西安航天总医院定期产检并分娩的880例高龄(年龄≥35岁)、单胎妊娠的经产妇及新生儿临床资料,根据产妇分娩间隔时间不同分为A组(1~4年)、B组(5~9年)和C组(≥10年),比较三组产妇并发症发生率、产程时间及新生儿出生情况。并分析高龄单胎妊娠经产妇不良妊娠结局的影响因素。[结果]C组产妇并发症总发生率为21.25%(34/160),显著高于A组的14.04%(48/342)和B组的11.11%(42/378)比较差异有统计学意义(P<0.05).但A组、B组产妇并发症总发生率比较差异无统计学意义(P>0.05);A组、B组、C组第一产程时间依次增加,且组间比较差异有统计学意义(P<0.05);C组新生儿出现窒息和转入重症监护室(ICU)比例显著高于A组和B组,其差异有统计学意义(P>0.05).但A组、B组新生儿出现窒息和转入ICU比例比较差异无统计学意义(P>0.05)。880例高龄单胎妊娠经产妇中有140例出现了不良妊娠结局,其发生率为15.91%。单因素分析结果显示:产妇年龄、分娩间隔时间、有流产史、不良妊娘习惯以及妊娠合并症与妊娠并发症等因素与不良妊娠结局有关(P<0.05);多因素Logistic回归分析结果显示:年龄≥42岁、分娩间隔时间≥10年、有流产史、不良妊娠习惯及妊娠合并症与妊娠并发症均为高龄妊娠经产妇发生不良妊娘结局的独立危险因素(P<0.05)。[结论]高龄单胎妊娠经产妇并发症发生率、第一产程时间、新生儿出现窒息和转入ICU的概率随着妊娠间隔时间的延长而增加。

[Objective]To explore the eflect of diferent gestatioral interval on the pregnancy outcome of elder-ly singleton pregnancy.[Methods]the clinical data of 880 cases of elderly singleton pregnancy in our hospital from January 2013 to December 2018 were retrospectively analyzed.According to the different delivery interval.they were divided into group A(1-4 years),group B(5-9 years)and groupC(≥10 years).The incidence of maternal complications.labor process time and neonatal birth of the three groups were compared.[Results]The total inci-dence of maternal complications in group C was 21.25%(34/160),which was significantly higher than that in group A(14.04%.48/342).and group B(11.11%.42/378).and the difference was statistically significant(P<0.05).But there was no significant difference in the total incidence of maternal complications between group A and groupB(P>0.05);the time of the first stage of labor in group A.group B and group C increased in turn,and the difference was statistically significant(P<0.05);The proportion of neonatal asphyxia and transfer to ICU in group C was significantly higher than that in group A and group B(P>0.05)but there was no significant differ-ence between group A and group B(P>0.05).Among 880 cases of single pregnancy,140 cases had adverse pregnancy outcomes,and the incidence rate was 15.91%.Univariate analysis showed that maternal age,delivery interval,abortion history,adverse pregnancy habits,pregnancy complications and pregnancy complications were related to adverse pregnancy outcome(P<0.05);multivariate logistic regression analysis showed that age≥42 years old,delivery interval≥10 years,abortion history,adverse pregnancy habits,pregnancy complications and pregnancy complications were independent risk factors for adverse pregnancy outcomes in elderly pregnant women(P<0.05).[Conclusion]The incidence of complications,the time of the first stage of labor,neonatal asphyxia and the probability of transferring to ICU increases with the extension of gestational interval.