二孩政策后孕妇高危妊娠发生情况及相关影响因素

Occurrence Condition of High-risk Pregnancy and Related Influencing Factors in Pregnant Women after Two-child Policy

目的:探讨二孩政策后孕妇高危妊娠发生情况及相关影响因素。方法:回顾性分析2017年7月—2020年6月广州市花都区妇幼保健院、广州市花都区天贵社区卫生服务中心产检及分娩的450例孕妇的临床资料。根据是否为高危妊娠将450例孕妇分为高危妊娠组及非高危妊娠组。分析两组临床资料。统计450例孕妇不同年份高危妊娠发生情况,分析孕妇高危妊娠发生的相关危险因素。结果:450例孕妇,高危妊娠180例,发生率为40.00%。其中2017年7—12月纳入孕妇80例,高危妊娠发生率为37.50%(30/80);2018年1—12月纳入孕妇130例,高危妊娠发生率为38.46%(50/130);2019年1—12月纳入孕妇140例,高危妊娠发生率为41.43%(58/140);2020年1—6月纳入孕妇100例,高危妊娠发生率为42.00%(42/100)。单因素分析显示,高危妊娠组年龄≥35岁、孕12周体重指数≥28 kg/m^(2)、引/流产史次数≥2次、产次≥2次、产前超声检查次数<5次、瘢痕子宫占比均高于非高危妊娠组,差异有统计学意义(P<0.05)。logistic回归分析显示,年龄≥35岁、孕12周体重指数≥28 kg/m^(2)、引/流产次数≥2次、产次≥2次、产前超声检查次数<5次、瘢痕子宫是孕妇发生高危妊娠的高危因素(P<0.05)。结论:二孩政策开放以来,孕妇高危妊娠发生率呈上升趋势,且年龄≥35岁、孕12周体重指数≥28 kg/m^(2)、引/流产史次数≥2次、产次≥2次、产前超声检查次数<5次、瘢痕子宫均是高危妊娠发生的危险因素,临床需加强干预,以改善母婴结局。

Objective:To investigate the occurrence condition of high-risk pregnancy and related influencing factors in pregnant women after two-child policy.Method:The clinical data of 450 pregnant women who underwent prenatal examination and delivery in Guangzhou Huadu District Maternal and Child Health Care Hospital,Guangzhou Huadu Tiangui Community Health Service Center from July 2017 to June 2020 were retrospectively analyzed,450 pregnant women were divided into high-risk pregnancy group and non-highrisk pregnancy group according to whether they were high-risk pregnancy or not.The clinical data of the two groups were analyzed.The occurrence condition of high-risk pregnancy in 450 pregnant women in different years was counted,and the related risk factors of highrisk pregnancy in pregnant women were analyzed.Result:Four hundred and fifty pregnant women,180 cases of high-risk pregnancy,the incidence was 40.00%.From July to December 2017,80 pregnant women were included,and the incidence of high-risk pregnancy was 37.50%(30/80).From January to December 2018,130 pregnant women were included,and the incidence of high-risk pregnancy was 38.46%(50/130).From January to December 2019,140 pregnant women were included,and the incidence of high-risk pregnancy was 41.43%(58/140).From January to June 2020,100 pregnant women were included,and the incidence of high-risk pregnancy was 42.00%(42/100).Univariate analysis showed that the proportions of age≥35 years old,body mass index≥28 kg/m^(2) at 12 weeks of gestation,the number of history of induction/abortion≥2 times,parity≥2 times,number of prenatal ultrasound examinations<5 times,and scarred uterus in the high-risk pregnancy group were higher than those in the non-high-risk pregnancy group,and the differences were statistically significant(P<0.05).logistic regression analysis showed that age≥35 years old,body mass index≥28 kg/m^(2) at 12 weeks of gestation,number of induction/abortion≥2 times,parity≥2 times,number of prenatal ultrasound examinations<5 times,and scarred uterus were the high-risk factors of high-risk pregnancy in pregnant women(P<0.05).Conclusion:Since the opening of two-child policy,the incidence of high-risk pregnancy in pregnant women has shown an upward trend,and the age≥35 years old,body mass index≥28 kg/m^(2) at 12 weeks of gestation,number of induction/abortion≥2 times,parity≥2 times,number of prenatal ultrasound examinations<5 times,and scarred uterus is risk factor for the occurrence of high-risk pregnancy,and clinical intervention needs to be strengthened to improve the outcome of mothers and babies.