北京市某妇幼保健机构产妇早产分娩时机及分娩方式的影响因素分析

Analysis of the influencing factors of delivery timing and mode of preterm maternal in a maternity and child care hospital in Beijing

目的分析北京市某妇幼保健院产妇早产分娩时机及分娩方式的影响因素。方法回顾性分析2017年1月至2019年12月该院早产孕产妇的一般临床资料,根据分娩孕周分为早中期早产组和晚期早产组,同时根据分娩方式将其分为自然分娩组和剖宫产组,比较不同组间孕产妇的一般临床特征,采用多因素Logistic回归分析早产分娩时机和分娩方式的影响因素。结果639例(5.42%)孕产妇发生早产,其中早中期早产132例(20.66%),晚期早产507例(79.34%);剖宫产328例(51.33%),自然分娩311例(48.67%)。年龄、不良产史、瘢痕子宫、孕期服用叶酸及妊娠合并症是早中期早产发生的独立影响因素,而年龄、BMI、多胎、瘢痕子宫及妊娠合并症是早产时选择剖宫产的独立影响因素。早中期早产儿1 min和10 min Apgar评分均显著低于晚期早产儿,1岁内死亡率显著高于晚期早产儿(P<0.05)。结论早产分娩时机及分娩方式主要受年龄、不良产史、瘢痕子宫和妊娠合并症等因素的影响,且早产的分娩时机影响早产儿结局。

Objective To investigate the influencing factors of delivery timing and delivery mode of preterm maternal in a maternity and child care hospital in Beijing.Methods The general clinical data of preterm maternal in the hospital from January 2017 to December 2019 were analyzed retrospectively and divided into the early and mid-preterm group and late preterm group according to the delivery weeks.And were also divided into the natural birth group and cesarean section group according to the delivery mode.Multi-factor Logistic regression was used to analyze the influence factors of delivery timing and delivery mode of maternal in different groups.Results 639 pregnant women(5.42%)had preterm birth,of which 132 cases(20.66%)had early and mid-preterm birth and 507 cases(79.34%)had late preterm birth.328 cases(51.33%)were delivered by cesarean section and 311 cases(48.67%)were delivered naturally.Age,adverse birth history,scar uterus,folic acid administration during pregnancy and complications of pregnancy were the independent factors of early and mid-preterm.Age,BMI,multiple births,scar uterus and complications of pregnancy were independent factors of cesarean section selection during premature delivery.The 1 min and 10 min Apgar scores of early and mid-preterm infants were significantly lower than those of late preterm infants,and the mortality within 1 year was significantly higher than that of the late preterm infants(P<0.05).Conclusion The delivery timing and delivery mode of maternal were mainly affected by age,adverse birth history,scar uterus and pregnancy complications,The delivery timing directly affected the outcome of preterm infants.