2016—2021年兰州市孕产妇不良妊娠结局影响因素分析

Study on the Influencing Factors of Adverse Pregnancy Outcomes in Pregnant and Postpartum Women in Lanzhou from 2016 to 2021

目的:调查2016—2021年兰州市孕产妇不良妊娠结局情况,分析孕产妇发生不良妊娠结局的高危因素,以期为不良妊娠结局的防治、优生优育的深入研究提供重要的参考依据。方法:从全国妇幼健康监测信息系统中抽取兰州市4家危重孕产妇监测医院2016—2021年住院分娩的孕产妇个案调查表(共174077份),采用SPSS 22.0软件进行统计分析,探讨孕产妇发生不良妊娠结局的影响因素。结果:孕产妇受教育程度越低,胎儿发生低出生体重的风险越小;孕产妇为单身/离异时,胎儿发生低出生体重的风险越大。受教育程度越低、妊娠次数及产次越多、年龄越大,孕产妇分娩巨大儿的风险越大。受教育程度越低,分娩时胎先露及臀先露,流产、产次及既往剖宫产次数越多,胎儿发生死胎死产的风险越高;分娩时选择剖宫产的胎儿发生死胎死产的风险越低。受教育程度越低,分娩时胎儿臀先露、肩先露及混合先露,单身/离异,年龄越大,妊娠次数及产次越多,产妇发生早产风险越高。结论:兰州市孕产妇发生不良妊娠结局情况不容乐观,不良妊娠结局受到多方面因素的影响。孕产妇自身及医疗机构应重视不良妊娠结局及相关危险因素,采取多种有效措施进行预防控制,以减少不良妊娠结局的发生。

OBJECTIVE To analyse the maternal adverse pregnancy outcomes in Lanzhou from 2016 to 2021,to understand the high-risk factors for adverse maternal pregnancy outcomes,and to provide an important reference for in-depth research on the prevention and treatment of adverse pregnancy outcomes and the improvement of eugenics.METHODS The maternal case questionnaires(a total of 184535 cases)of inpatient pregnancies from 2016 to 2021 in 4 hospitals monitoring critical maternal health in Lanzhou were extracted from the National Maternal and Child Health Monitoring Information System.RESULTS The lower the maternal education level,the lower the risk of low birth weight.The risk of low birth weight was greater when the mother was single/divorced/widowed.Low education level,more pregnancies and births,and older women were at greater risk of giving birth to large babies.The lower the education level,the more fetal and gluteal presentations during delivery,the more miscarriages,the number of births,and the number of previous cesarean sections,the higher the risk of fetal stillbirth.The lower the risk of stillbirth was for fetuses who opted for cesarean section at delivery.The risk of preterm birth increased with lower education level,hip,shoulder and mixed presentation during delivery,single/divorced/widowed,older age,and more pregnancies and births.CONCLUSION The adverse pregnancy outcome of pregnant women in Lanzhou is not optimistic,and the adverse pregnancy outcome is affected by many factors.Pregnant women themselves and medical institutions should pay attention to adverse pregnancy outcomes and related risk factors,take a variety of effective measures to prevent and control,reduce the occurrence of adverse pregnancy outcomes.