1000例产妇早产的影响因素分析

The influencing factors analysis of premature delivery in 1000 pregnant women

目的通过分析早产的相关影响因素,为早产的预防提供参考依据。方法将2017年1月1日至12月31日在该院生产的14791例单胎妊娠孕妇,按生产孕周分为早产组(28~36+6周分娩,1000例)和足月组(37周及以后分娩,13791例)。从该院电子信息系统收集整理两组的临床资料并进行比较,分析引发早产的相关影响因素。结果高中及以下受教育程度的产妇发生早产的风险是大专及以上学历产妇的1.69倍;有早产史(OR:4.61,95%CI:3.45~6.14)、有剖宫产史(OR:1.47,95%CI:1.24~1.74)和流产次数≥3次(OR:1.45,95%CI:1.11~1.90)的产妇发生早产的风险增加;前置胎盘、妊娠期高血压疾病、胎膜早破、羊水异常、珠蛋白生成障碍性贫血(以下简称地贫)或携带地贫基因以外的贫血、妊娠期糖尿病(GDM)及孕前糖尿病(PGDM)等妊娠期合并症及并发症会引起早产风险增高,其OR值和95%CI分别为16.96(11.95~24.07)、4.45(3.63~5.47)、4.17(3.60~4.82)、2.32(1.73~3.10)、1.38(1.18~1.61)、1.33(1.14~1.54)(P<0.05)。结论高中及以下受教育程度、有早产史、有剖宫产史、流产次数≥3次、前置胎盘、妊娠期高血压疾病、胎膜早破、羊水异常、地贫或携带地贫基因以外的贫血、GDM及PGDM是发生早产的危险因素,准确、及时识别这些早产高危因素,为孕妇提供科学的孕期保健和个性化的防治措施是改善分娩结局和预防早产的重要手段。

Objective To provide reference for the prevention of premature delivery by analyzing the related influencing factors of premature delivery.Methods A total of 14791 singleton pregnant women who gave birth in Fujian Maternity and Child Health Hospital from January 1 to December 31,2017 were divided into preterm group(28-36+6 weeks of delivery,1000 cases)and term group(37 or after 37 weeks of delivery,13791 cases)according to their gestational weeks.The clinical data of the two groups were collected and compared from the electronic information system,and the related influencing factors of premature birth were analyzed.Results The risk of preterm delivery was 1.69 times higher in women with high school education or below than that in women with college education or above.Women with a history of preterm birth(OR:4.61,95%CI:3.45-6.14),cesarean section(OR:1.47,95%CI:1.24-1.74),history of three or more miscarriages(OR:1.45,95%CI:1.11-1.90)had increased risk of premature delivery.Placenta previa,hypertensive disorders during pregnancy,premature rupture of membranes,abnormal amniotic fluid,anemia excepting for thalassemia or gene carrier,gestational diabetes(GDM),diabetes before pregnancy(PGDM)and other complications during pregnancy could increase the risk of premature delivery.The OR value and 95%CI were 16.96(11.95-24.07),4.45(3.63-5.47),4.17(3.60-4.82),2.32(1.73-3.10),1.38(1.18-1.61),1.33(1.14-1.54)respectively(P<0.05).Conclusion High school education or below,history of premature delivery and cesarean section,history of three or more miscarriages,placenta previa,hypertensive disorder during pregnancy,premature rupture of membranes,abnormal amniotic fluid,anemia excepting for thalassemia or gene carrier,GDM and PGDM are risk factors for premature delivery,accurate and timely identification of these risk factors,providing pregnant women with scientific pregnancy care,personalized prevention and treatment measures is important means to improve the outcome of childbirth and prevent premature delivery.