重度子痫前期孕妇的妊娠结局分析

Analysis of pregnancy outcomes in pregnant women with severe preeclampsia

目的比较不同年龄的重度子痫前期孕妇妊娠结局和围生儿结局。方法收集2019年12月—2020年12月在甘肃省妇幼保健院就诊并分娩的592例重度子痫前期孕妇的完整资料,按照孕妇是否高龄分为两组,其中高龄组(年龄≥35岁)110例,对照组(年龄<35岁)482例,回顾性分析两组孕妇的一般情况、妊娠结局、合并症及围生儿结局。结果高龄组出现不良妊娠结局62例(56.36%),低蛋白血症47例(42.73%),对照组出现不良妊娠结局203例(42.12%),低蛋白血症107例(22.20%),差异均有统计学意义(均P<0.05)。高龄组孕妇妊娠合并贫血、妊娠期糖尿病、妊娠合并甲状腺功能减退症的发生率均高于对照组(均P<0.05)。高龄组胎儿生长受限、胎儿窘迫、围生儿死胎/引产的发生率均高于对照组(均P<0.05)。高龄组新生儿出生1 min Apgar评分<8分者有17例(15.45%),对照组有43例(8.92%),高龄组明显高于对照组(χ^(2)=4.197,P<0.05)。结论高龄重度子痫前期孕妇的不良妊娠结局发生率较高,对高龄孕妇的规范管理是预防母儿并发症、避免不良妊娠结局和围生儿结局的关键。

Objective To compare the pregnancy outcomes and perinatal outcomes of pregnant women with severe preeclampsia at different ages.Methods The complete data of 592 pregnant women with severe preeclampsia who delivered in Gansu Provincial Maternity and Child-care Hospital from December 2019 to December 2020 were collected.The pregnant women were divided into two groups according to whether they were elderly pregnant women:110 cases in elderly group(more than or equal to 35 years old)and 482 cases in control group(less than 35 years old).The general situation,pregnancy outcomes and complications,and perinatal outcomes of pregnant women in the two groups were analyzed retrospectively.Results In elderly group,62 cases(56.36%)were found with adverse pregnancy outcomes,47 cases(42.73%)were found with hypoproteinemia.In control group,203 cases(42.12%)were found with adverse pregnancy outcomes,107 cases(22.20%)were found with hypoproteinemia.There were statistically significant differences(P<0.05).In elderly group,the incidence rates of pregnancy complicated with anemia,gestational diabetes mellitus,pregnancy complicated with hypothyroidism were higher than those in control group(P<0.05).In elderly group,the incidence rates of fetal growth restriction,fetal distress,perinatal stillbirth or induced labor were higher than those in control group(P<0.05).In elderly group,the proportion of neonatal one-minute Apgar score<8 was 15.45%(17 cases),which was higher than that in control group(43 cases,8.92%),there was statistically significant difference(χ^(2)=4.197,P<0.05).Conclusion The incidence rate of adverse pregnancy outcomes in elderly pregnant women is high.The standard management of elderly pregnant women is the key to prevent maternal and infantile complications and avoid adverse pregnancy and perinatal outcomes.