妊娠合并心脏病孕妇心功能情况及不良妊娠结局影响因素分析

Analysis of factors affecting cardiac function and adverse pregnancy outcome in pregnant women with heart disease

目的探讨妊娠合并心脏病孕妇心功能情况及不良妊娠结局影响因素,为临床提供理论参考。方法选取自2017年1月至2022年6月收治的257例妊娠合并心脏病孕妇作为研究对象,统计孕妇的心脏病类型和心功能情况,比较心功能1~2级和3~4级孕妇的妊娠结局,分析孕妇不良妊娠结局的影响因素。结果257例妊娠合并心脏病孕妇中,先天性心脏病占40.1%(103/257),瓣膜性心脏病占35.8%(92/257),功能性心脏病占17.5%(45/257),其他类型占6.6%(17/257)。心功能分级1级占56.8%(146/257),心功能分级2级占26.5%(68/257),心功能分级3级占13.6%(35/257),心功能分级4级占3.1%(8/257)。心功能分级1~2级孕妇早产、产后出血及胎儿出生缺陷比例明显低于心功能分级3~4级,差异有统计学意义(P<0.05)。Logistic多因素回归分析显示,孕次、心功能分级、心脏病类型、高血压是妊娠合并心脏病的独立危险因素(P<0.05)。结论妊娠合并心脏病孕妇的心功能以1~2级为主,心功能分级低的孕妇不良妊娠结局发生率相对较低。孕次、心功能分级、心脏病类型、高血压是妊娠合并心脏病孕妇不良妊娠结局的独立危险因素。

Objective To investigate the cardiac function and adverse pregnancy outcome of pregnant women with heart disease,and provide theoretical reference for clinical practice.Methods A total of 257 pregnant women with heart disease who were admitted from January 2017 to June 2022 were selected as the research objects.The types of heart disease and cardiac function of pregnant women were examined.The pregnancy outcomes of pregnant women with grade 1-2 and grade 3-4 cardiac function were compared and were analyzed the influencing factors of adverse pregnancy outcomes in pregnant women.Results Among the 257 pregnant women with heart disease,congenital heart disease accounted for 40.1%(103/257),valvular heart disease 35.8%(92/257),functional heart disease 17.5%(45/257),and other heart disease 6.6%(17/257).In the grading of cardiac function,56.8%(146/257)were grade 1,26.5%(68/257)were grade 2,13.6%(35/257)were grade 3,3.1%(8/257)were grade 4.The rates of preterm labor,postpartum hemorrhage and fetal birth defects in grade 1 to 2 were significantly lower than those in grade 3 to 4,and the difference was statistically significant(P<0.05).Pregnancy number,cardiac function grade,type of heart disease and hypertension were independent risk factors for adverse pregnancy outcomes in pregnant women with heart disease(P<0.05).Conclusion The heart function of pregnant women with heart disease is mainly grade 1-2,and the incidence of adverse pregnancy outcome is relatively low in pregnant women with low heart function grade.Pregnancy number,cardiac function grade,type of heart disease and hypertension were independent risk factors for adverse pregnancy outcomes in pregnant women with heart disease.