孕前及孕期保健对高龄产妇不良妊娠结局的改善效果

Analysis of Adverse Pregnancy Outcomes in Elderly Parturients and Prevention and Control Strategies

目的:分析孕前及孕期保健对高龄产妇不良妊娠结局的影响,旨在为临床相关防治策略的制定提供参考。方法:选取2019年2月—2021年3月在闽清县总医院进行妊娠期检查的204名高龄产妇为研究对象。通过随机数表法将其分为对照组和观察组,每组各102人。给予对照组产妇常规检测,观察组在对照组常规检测基础上给予产妇孕前及孕期保健。观察并比较两组产妇妊娠并发症、不良妊娠结局发生率、心理状态、新生儿出生缺陷率和Agar评分情况。结果:观察组产妇产后出血、妊娠高血压、糖尿病发生率分别为2.94%、7.84%、23.53%,均低于对照组,差异有统计学意义(χ^(2)值分别为11.464、14.262和6.473,P值均<0.05)。观察组产妇流产、早产、胎膜早破发生率分别为12.75%、2.94%、1.96%,均低于对照组,差异有统计学意义(χ^(2)值分别为5.358、4.605和7.196,P值均<0.05)。观察组产妇妊娠1个月、妊娠6个月和分娩24小时的SAS评分和SDS评分均低于对照组。观察组新生儿低体重、巨大儿和新生儿总缺陷率分别为4.49%、3.37%和8.99%,均低于对照组,差异有统计学意义(χ^(2)值分别为13.064、8.831和29.225,P值均<0.05)。观察组新生儿呼吸、皮肤颜色、心搏速率、肌张力和反射评分分别为(1.45±0.16)分、(1.51±0.18)分、(1.48±0.37)分、(1.17±0.36)分、(1.60±0.22)分,均高于对照组,差异有统计学意义(t值分别为19.490、12.445、7.744、5.064和8.167,P值均<0.05)。结论:采用孕前及孕期保健有助于改善高龄产妇心理状态,降低不良妊娠结局、妊娠并发症和新生儿缺陷发生率,提高新生儿身体素质,具有较好临床应用价值。

OBJECTIVE To analyze the influence of pre-pregnancy and prenatal health care on adverse pregnancy outcomes of elderly parturients and its prevention and treatment strategies.METHODS 204 elderly pregnant women who underwent pregnancy examination in Minqing County General Hospital from February 2019 to March 2021 were randomly divided into control group and observation group,with 102 cases in each group.Control group:maternal routine detection was given;observation group:maternal pre-pregnancy and pregnancy health care was given on the basis of control group routine detection.The incidence of pregnancy complications,adverse pregnancy outcomes,psychological status,birth defects and Agar scores of the two groups were observed and compared.RESULTS The rates of postpartum hemorrhage,gestational hypertension and diabetes in the observation group were 2.94%,7.84%and 23.53%,respectively,which were lower than those in the control group,and the differences were statistically significant(χ^(2)=11.464,14.262,6.473,P<0.05).The incidence of abortion,premature delivery and premature rupture of membranes in the observation group was 12.75%,2.94%and 1.96%,respectively,which were lower than those in the control group,and the difference was statistically significant(χ^(2)=5.358,4.605,7.196,P<0.05).The SAS scores and SDS scores at 1 month of gestation,6 months of gestation and 24 hours of delivery in the observation group were lower than those in the control group.The rates of low birth weight,macrosomia and total defects in the observation group were 4.49%,3.37%and 8.99%,respectively,which were lower than those in the control group,and the difference was statistically significant(χ^(2)=13.064,8.831,29.225,P<0.05).The scores of respiration,skin color,heart rate,muscle tone and reflexes in the observation group were(1.45±0.16)points,(1.51±0.18)points,(1.48±0.37)points,(1.17±0.36)points and(1.60±0.22)points,respectively,which were higher than those in the control group.The difference was statistically significant(t=19.490,12.445,7.744,5.064,8.167,P<0.05).CONCLUSION The use of prenatal health care before pregnancy can help improve the psychological state of elderly women,reduce the incidence of adverse pregnancy outcomes,reduce the incidence of pregnancy complications and neonatal defects,and improve the physical fitness of newborns,which has good clinical application value.