胎动减少后不良妊娠结局的风险预测研究  

Risk prediction study of reduced fetal movements on adverse pregnancy outcomes

作　　者：于达 宋雁 林艳[2] 

机构地区：[1]大连妇产暨妇幼保健院妇产科,辽宁大连116033 [2]吉林省中医药科学院,吉林长春130015

出　　处：《中国当代医药》2013年第18期28-30,共3页China Modern Medicine

基　　金：吉林省中医药管理局中医药科技项目(2011-js22)

摘　　要：目的预测胎动减少(RFM)的不良妊娠结局的风险因素。方法收集215例妊娠28周及以上、报告胎动减少孕妇的流行病学资料和临床资料,记录超声对胎儿生长发育的指标以及羊水、多普勒脐血流的监测,测定母亲外周血中胎盘分泌的生化指标:胎盘相关性蛋白(PAPP-A)、血清人绒毛膜促性腺激素(HCG)、甲胎蛋白(AFP)及孕酮(P),利用逻辑回归统计方法对各因素进行关联分析。结果在报告胎动减少的孕妇中出现不良妊娠结局的比例为15%,最多见的异常结局为低出生体重儿。影响妊娠结局的相关因素包括胎动的次数、异常胎心率、舒张期血压、预测的胎儿体重以及人类胎盘催乳素(HPL)。多元逻辑回归研究显示,异常胎心率(OR=7.02,95%CI为1.53～35.23),舒张期血压(OR=1.16,95%CI为1.10～1.20),预测的胎儿体重(OR=0.89,95%CI为0.87～0.90),HPL(OR=0.13,95%CI为0.02～0.99)是影响妊娠结局的独立风险因素。结论胎动减少后发生的不良妊娠结局与反映胎盘功能的相关指标紧密相关。Objective To predict the risk factors of reduced fetal movements （RFM） on adverse pregnancy outcomes. Methods The epidemiological and clinical data from 215 pregnant women with more than 28 weeks of gestation and reduced fetal movements were collected. The indexes of fetal growth and development were recorded by ultrasound.The amniotic fluid and umbilical blood flow by Doppler were monitored.The secreted biochemical indicators by placenta in maternal peripheral blood like pregnancy associated plasma protein A （PAPP -A）, human chorionic gonadotropin （HCG）,Alpha fetal protein （AFP） and progesterone （P） were measured. The correlation analysis of above-mentioned factors was utilized by logistic regression. Results The incidence of adverse pregnancy outcome in these women with RFM was 15%.The neonate with lower birth weight was the most common abnormal outcome. The relevant factors influencing on pregnancy outcome included fetal movement times,abnormal fetal heart rate,diastolic blood pressure （DBP）,predicted fetal weight,and human placenta lactogen （HPL）.The multivariate logistic regression displayed abnormal fetal heart rate （OR=7.02,95%CI was 1.53-35.23）, DBP （OR=1.16,95%CI was 1.10-1.20）,predicted fetal weight （OR=0.89, 95%CI was 0.87-0.90）, and HPL （OR=0.13,95%CI was 0.02-0.99） were all independent risk factors affecting pregnancy outcomes. Conclusion The adverse pregnancy outcome occurred after RFM is closely related with relevant indexes reflecting on placental function.

关 键 词：胎动减少 胎盘功能 不良妊娠结局 

分 类 号：R714[医药卫生—妇产科学]