1421例治疗性晚期早产的相关危险因素分析  

Study on the Related Risk Factors of 1 421Cases of Iatrogenic Late Preterm Birth

作　　者：陈海霞[1] 孙波[1] 骆秀翠[1] 

机构地区：[1]连云港市妇幼保健院产科,江苏222006

出　　处：《中华妇幼临床医学杂志（电子版）》2014年第1期62-65,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的 探讨治疗性晚期早产的相关危险因素,降低晚期早产发生率.方法选择2001年1月至2011年6月于连云港市妇幼保健院就诊的1 421例治疗性晚期早产患者为研究对象,纳入研究组（n=1 421）;并按照入院顺序随机抽取同期就诊的1 288例足月分娩产妇为对照组（n=1 288）（本研究遵循的程序符合连云港市妇幼保健院人体试验委员会所制定的伦理学标准,得到该委员会批准,分组征得受试对象本人的知情同意,并与之签署临床研究知情同意书）.应用单因素分析和多因素非条件logistic回归分析筛选晚期早产的相关危险因素.结果 两组新生儿出生体质量、平均住院时间、新生儿期并发症发生率比较,差异有统计学意义（P〈0.01）,而两组死亡率比较,差异无统计学意义（P〉0.05）.胎膜早破[OR=5.442,95%CI（3.53～8.40）;P〈0.001]、双胎[OR=7.918,95%CI（3.52～17.81）;P〈0.001]、重度子痫前期[OR=13.234,95%CI（6.28～27.87）;P〈0.001]与晚期早产密切相关.结论 胎膜早破、双胎、重度子痫前期、前置胎盘及胎盘早剥是治疗性晚期早产的相关因素,其中,前三者是其独立危险因素.推行孕前咨询及产前检查,加强围生期管理,进行早产二级预防,开展对自发性早产的预测,可延长孕周,降低治疗性晚期早产发生率.Objective To investigate the clinical factors associated with iatrogenic late preterm birth. Methods From January 2001 to June 2011, 1 421 women with late preterm birth in the Maternity and Child Hospital of Lianyungang were included in the study as research group（n=1 421）.Meanwhile 1 288 full-term pregnant women were randomly selected as control group（n=1 288）.Clinical factors associated with iatrogenic late preterm birth were selected by logistic regression analysis method to provide basis for establishing the system. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of the Maternity and Child Hospital of Lianyungang.Informed consent was obtained from each patients. Results There had significant differences between two groups in birth weight,hospital duration,neonatal complications（P〈0.01）,and there was no significant difference in mortality rate between two groups （P〉0.05）. Logistic regression analysis showed that premature rupture of membranes[OR=5.442,95%CI（3.53-8.40）;P〈0.001], twin pregnancy[OR=7.918,95%CI（3.52-17.81）;P〈0.001], preeclampsia[OR=13.234,95%CI（6.28-27.87）;P〈0.001], placenta and placenta abruption were related risk factors for iatrognic late preterm birth, among which premature rupture of membranes, twin pregnancy, preeclampsia were the independent risk factors. Conclusions Premature rupture of membranes, twin pregnancy, preeclampsia, placenta and placenta abruption were the risk factors associated with iatrognic late preterm birth. Implementing preconception counseling and inspection,strengthening the perinatal management,completing two levels of prevention and carrying prediction of spontaneous preterm labor can prolong the gestational age, lower the iatrognic late preterm birth rate.

关 键 词：晚期早产 危险因素 LOGISTIC回归分析 

分 类 号：R722.6[医药卫生—儿科]