子痫前期及其高危因素对围产儿结局的不良影响  

Adverse perinatal outcomes in preeclampsia and risk factors

作　　者：蒋萌[1] 林建华[1] 

机构地区：[1]上海交通大学医学院附属仁济医院妇产科,上海200127

出　　处：《现代妇产科进展》2013年第5期360-363,共4页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨子痫前期(PE)及其高危因素对围产儿结局的影响。方法:根据国内外资料统计的PE高危因素,筛选2011年4月至2012年1月在上海交通大学医学院附属仁济医院妇产科产检和分娩的正常及存在高危因素的孕妇154例,最终发展为PE的孕妇50例,非PE孕妇104例。通过采集病史及实验室检查,追踪妊娠结局,分析PE及存在高危因素PE孕妇的围产儿结局。结果:(1)PE组的新生儿体重及分娩孕周显著小于非PE组(P<0.05)。(2)PE组的胎儿生长受限(FGR)、胎儿窘迫、早产、死胎、新生儿窒息发生率分别是非PE组的4.64倍、2.32倍、4.61倍、2.66倍、6.38倍。两组的FGR、胎儿窘迫、早产的发病率有显著差异(P<0.05)。(3)当MAP≥85mmHg、蛋白尿、子宫/脐动脉血流异常、D-D>0.246μg/ml、FDP>4μg/ml、PAGT>40%时,易发生围产儿不良结局(P均<0.05)。不同高危因素对围产儿结局的威胁程度不同,其中子宫/脐动脉血流异常时围产不良结局发生率均较高(P<0.05)。结论:PE对围产儿结局有不良影响。孕期可针对高危孕妇进行严格有效的筛查,严密监测围产儿生长发育,警惕PE及围产儿不良结局的发生。Objective：To investigate the impact of preeclampsia （PE） and risk factors for perinatal outcomes. Methods：According to research status at home and abroad, a random investigation of 154 pregnant women with or without high-risk factors, who did pre-pregnancy physical examinations and deliveries from Apr. 2011 to Jan. 2012 at Renji Hospital, Medical School of Shanghai Jiaotong University. Finally, there were 50 cases of PE and 104 cases of non- PE. Perinatal outcomes in preeclampsia and risk factors were analyzed by tracking pregnancy outcomes with acquisition of medical history and laboratory tests. Results： （ 1 ） Neonatal weight and gestational age of the preeclampsia group was significantly less than that of the non-preeclampsia group. （2）The multiple of incidence rate in preeclampsia group was 4.64 times, 2. 32 times,4.61 times,2.66 times and 6.38 times, respectively, compared to non-preeclampsia group in fetal growth restriction （FGR）, fetal distress, premature delivery, stillbirth and neonatal asphyxia,while the incidence of FGR, fetal distress and preterm birth were statistically signifi- cant higher （P〈0.05）. （3）Neonatal asphyxia, FGR, fetal distress and perinatal death rate increased significantly when MAP t〉 85mmHg, proteinuria, abnormal uterine/umbilical artery blood flow, DD〉0. 246μg/ml, FDP〉4μg/ml, PAGT〉40%. Different risk factors threatened perinatal outcome differently while the abnormal uterine/umbilical artery blood flow threatened most （ P 〈 0.05 ）. Conclusions ： Preeclampsia can lead to adverse perinatal outcomes. It may help to prevent PE and perinatal adverse outcomes women and close monitoring of the growth. with strict screening for high-risk pregnant

关 键 词：子痫前期 高危因素 围产儿结局 

分 类 号：R714.7[医药卫生—妇产科学]