超高龄孕妇的单中心回顾性研究

A single-center retrospective study of super-aged pregnant women

目的探讨超高龄孕妇的临床特征及母婴结局。方法回顾性分析2017年1月至2022年6月于徐州医科大学附属妇幼保健院住院分娩孕妇的临床资料,根据孕妇的年龄将其分为超高龄组(年龄≥40岁,1822例)和适龄组(年龄<35岁,1827例)。比较两组孕妇的一般情况、妊娠合并症和并发症、分娩结局、新生儿结局。结果超高龄组孕妇的孕次、产次均显著多于适龄组,分娩孕周早于适龄组(P<0.01),两组孕妇的辅助生殖助孕比例差异无统计学意义(P>0.05)。超高龄组孕妇的妊娠高血压、妊娠糖尿病、瘢痕子宫、前置胎盘、早产发生率均显著高于适龄组(P<0.05),胎膜早破、胎盘早剥、胎儿窘迫发生率均显著低于适龄组(P<0.05)。超高龄组孕妇的剖宫产率、子宫捆绑术比例均显著高于适龄组(P<0.05),阴道分娩率、会阴侧切率均显著低于适龄组(P<0.05)。两组新生儿的平均体质量比较差异无统计学意义(P>0.05),超高龄组的低出生体质量儿、巨大儿、新生儿窒息率均显著高于适龄组(P<0.05)。结论超高龄孕妇的妊娠合并症和并发症、剖宫产率、新生儿并发症发生率均增加,应高度重视超高龄孕妇的孕期保健及围生期管理。

Objective To investigate the clinical features and maternal and infant outcomes of super-aged pregnant women.Methods The clinical data of pregnant women who gave birth in Maternity and Child Health Care Hospital Affiliated to Xuzhou Medical University from January 2017 to June 2022 were retrospectively analyzed.According to the age of pregnant women,they were divided into super-aged group(≥40 years old,1822 cases)and age-appropriate group(<35 years old,1827 cases).The general conditions,pregnancy complication and comorbidity,delivery outcomes and neonatal outcomes of two groups were compared.Results The number of pregnancies and number of delivery in super-aged group were significantly higher than those in age-appropriate group,and the gestational week of delivery was earlier than that in age-appropriate group(P<0.01).There was no statistical significance in the proportion of assisted reproduction between two groups(P>0.05).The incidences of gestational hypertension,gestational diabetes mellitus,scarring uterus,placenta previa and preterm delivery in super-aged group were significantly higher than those in age-appropriate group(P<0.05),while the incidences of premature rupture of membranes,placental abruption and fetal distress were lower than those in age-appropriate group(P<0.05).The rate of cesarean section and the proportion of uterine binding in super-aged group were significantly higher than those in age-appropriate group(P<0.05),and the rates of vaginal delivery and lateral perineal resection were significantly lower than those in age-appropriate group(P<0.05).There was no significant difference in the average body weight of newborns between the two groups(P>0.05),but the rates of low birth weight infants,macrosomia and neonatal asphyxia in super-aged group were significantly higher than those in age-appropriate group(P<0.05).Conclusion The incidences of pregnancy complications and comorbidity,cesarean section and neonatal complications increased in super-aged pregnant women.We should attach great importance to the prenatal health care and perinatal management of super-aged pregnant women.