甘肃地区329例双胎妊娠结局的影响因素分析

Analysis of factors affecting the outcome of 329 twin pregnancies in Gansu province

目的 探讨双胎妊娠的母儿不良结局的影响因素,进一步提升对双胎妊娠的规范化管理。方法 收集2019年1月至2021年1月在甘肃省妇幼保健院分娩的329例双胎活产的临床资料,以孕妇不良妊娠结局74例为研究组,余255例为对照组;以围生儿不良妊娠结局222例为研究组,余107例为对照组。通过Logistic回归分析得出母儿不良结局的危险因素。结果 多因素Logistic回归分析结果显示,年龄、受孕方式和绒毛膜性是双胎妊娠母体出现不良妊娠结局的危险因素(P<0.05),年龄、绒毛膜性是双胎双胎妊娠胎儿不良妊娠结局的危险因素(P<0.05)。结论 孕妇高龄、经辅助生殖受孕、单绒毛膜双胎均是母体出现孕期并发症的危险因素,对于双胎妊娠的孕妇,当高龄、辅助生殖受孕和单绒毛膜双胎三个高危因素叠加时,应加强随访、规范孕期管理,可降低产科母体并发症;新生儿不良妊娠结局的危险因素是孕妇的年龄和绒毛膜性,和孕妇的受孕方式关系不大。在孕期管理中应加强高龄、单绒毛膜双胎的管理,严密监测胎儿生长发育,可提高围生儿出生质量。

Objective To explore the influencing factors of adverse maternal and child outcomes in twin pregnancies and further improve the standardized management of twin pregnancies. Methods Clinical data of 329 cases of live twin births in our hospital from January 2019 to January 2021 were collected. 74 cases of pregnant women with adverse pregnancy outcomes were selected as the study group, and 255 cases were selected as the control group. 222 cases of perinatal adverse pregnancy outcome were selected as study group and 107 cases as control group. Risk factors of adverse outcomes of mothers and children were obtained through logistics regression analysis. Results Multifactorial Logistic regression analysis showed that age,conception method and chorionicity were risk factors for adverse maternal pregnancy outcomes in twin pregnancies(P<0.05), age and chorionality were risk factors for adverse fetal pregnancy outcomes in twin pregnancies(P<0.05). Conclusion Maternal advanced age, conception by assisted reproduction, and monochorionic twin fetus are risk factors for maternal complications during pregnancy, and in twin pregnancies, when the three high-risk factors of advanced age, conception by assisted reproduction, and monochorionic twin fetus are superimposed, follow-up and standardized pregnancy management should be strengthened to reduce maternal complications in obstetrics. Risk factors for adverse neonatal pregnancy outcome are maternal age and chorionicity, and are not related to maternal. The risk factors for adverse neonatal pregnancy outcomes are maternal age and chorionicity, and have little relationship with the mode of conception. In the management of pregnancy, the management of advanced age and single chorionic twins should be strengthened and fetal growth and development should be closely monitored, which can improve the quality of perinatal births.