妊娠晚期胎儿生长受限的影响因素及干预方法

Influencing factors and intervention methods of fetal growth restriction in the third trimester of pregnancy

目的探讨妊娠晚期胎儿生长受限的影响因素及干预方法。方法回顾性分析2018年1月至2020年6月深圳市中西医结合医院237例妊娠晚期孕妇的临床资料,根据其是否发生胎儿生长受限分为胎儿生长受限组(n=50)和胎儿生长正常组(n=187),采用单因素、多因素Logistic回归分析妊娠晚期胎儿生长受限的影响因素。结果胎儿生长受限组孕妇的年龄与吸烟、饮酒、合并妊娠期糖尿病、合并妊娠期高血压占比及胎儿染色体异常、脐带过短、脐带缠绕及胎盘异常占比均高于胎儿生长正常组,差异有统计学意义(P<0.05);两组孕妇身高、产次及体重指数(BMI)比较差异无统计学意义。多因素Logistic回归分析结果显示,孕妇年龄较大、吸烟、饮酒、合并妊娠期糖尿病、合并妊娠期高血压及胎儿染色体异常、脐带过短、脐带缠绕及胎盘异常均为妊娠晚期胎儿生长受限发生的独立危险因素(P<0.05)。结论妊娠晚期胎儿生长受限的发生易受母体、胎儿、脐带及胎盘等多方面因素的影响,临床需进一步加强对高危因素孕妇孕期保健及监测,还需积极做好孕妇妊娠期疾病防治工作,以减少胎儿生长受限的发生。

Objective To explore the influencing factors and intervention methods of fetal growth restriction in the third trimester of pregnancy.Methods The clinical data of 237 pregnant women in the third trimester of pregnancy in Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from January 2018 to June 2020 were retrospectively analyzed,they were divided into the fetal growth restriction group(n=50)and the normal fetal growth group(n=187)according to whether had fetal growth restriction,univariate and multivariate regression were used to ana-lyze the influencing factors of fetal growth restriction in the third trimester.Results The age and the proportion of smoking,drinking,gestational dia-betes mellitus,gestational hypertension of pregnant women,and fetal chromosome abnormality,umbilical cord too short,umbilical cord entangling and placental abnormality in the fetal growth restriction group were higher than those in the normal fetal growth group,the differences were statisti-cally significant(P<0.05);there was no statistically significant difference in height,birth time and body mass index(BMI)of pregnant women be-tween the two groups.Multivariate Logistic regression analysis showed that older age,smoking,drinking,gestational diabetes mellitus and gestation-al hypertension,fetal chromosome abnormality,umbilical cord too short,umbilical cord entangling and placental abnormality were independent risk factors for fetal growth restriction in the third trimester of pregnancy(P<0.05).Conclusion The occurrence of fetal growth restriction in the third trimester is easily affected by many factors such as the mother's body,fetus,umbilical cord,and placenta,it is not only necessary to further strength-en pregnancy health care and monitoring for high-risk factors during pregnancy,but also to actively prevent and treat maternal diseases during preg-nancy to reduce the incidence of fetal growth restriction.