高龄初产妇前置胎盘的高危因素与妊娠结局分析  

Risk factors and outcomes of placenta previa among uniparas over thirty-five years old

作　　者：张红卫[1] 郭利 

机构地区：[1]首都医科大学附属北京妇产医院产科病房,100026

出　　处：《中华现代护理杂志》2014年第28期3569-3572,共4页Chinese Journal of Modern Nursing

摘　　要：目的：了解高龄初产妇前置胎盘的发生率、高危因素及妊娠结局。方法以医院为基础收集资料，共纳入1065人为研究对象。用χ2检验分析比较高龄初产妇在人口学资料、妊娠分娩因素及妊娠并发症等条件下前置胎盘的发生率，用多因素Logistic回归模型分析前置胎盘的高危因素及不良结局。结果所有1065名高龄初产妇中，905人（85．0％）未发生产后出血，160人（15．0％）发生产后出血。160名产后出血的高龄初产妇中，13人（8．13％）发生前置胎盘；950名未产后出血的高龄初产妇中，12人（1．33％）发生前置胎盘。所有高龄初产妇中，前置胎盘发生率在是否产后出血、是否宫缩乏力者间的比较，差异有统计学意义（χ2值分别为24．53，12．10；P＜0．05），在其他妊娠并发症中前置胎盘的发生率比较，差异无统计学意义（ P＞0．05）。在所有高龄初产妇中，未发现人口学及妊娠产前相关因素，前置胎盘的不良结局为早产（AOR：3．26，95％CI：1．43∽7．44）、产后出血（AOR：5．38，95％CI：2．37∽12．23）；在产后出血的高龄初产妇中，前置胎盘的不良结局为早产（AOR：6．28，95％CI：1．65∽23．82）。结论高龄初产妇是前置胎盘的高危人群，应尽快确认不良结局，以便及早采取应对措施。Objective To investigate the incidence , risk factors and pregnancy outcomes of placenta previa among uniparas aged over thirty-five.Methods This hospital-based study included 1 065 objects from June 2011 to May 2012 .The chi-square test was used to compare the incidence of placenta plavia among demographic information , obstetric risk factors , and maternal pregnancy outcomes .And the multiple logistic model was used to identify the risk factors independently associated with placenta previa .Results Totals of 160 （15.0%） uniparas had postpartum hemorrhage , while 905 （85.0%） uniparas did not.Within the 160 uniparas, 13（8.13%） uniparas had placenta previa , while within the 950 uniparas, 12（1.33%） uniparas had placenta previa .There were significant differences in the incidence of placenta previa , postpartum hemorrhage and uterine inertia （χ2 =24.53, 12.10, respectively;P〈0.05）.The other complications had no significant difference （P〉0.05）.Identified adverse pregnancy outcomes were being born at a gestational age below 37 weeks （AOR：3.26, 95%CI：1.43-7.44）, postpartum hemorrhage （AOR：5.38, 95%CI：2.37-12.23） and no prenatal risk factors were found .The adverse outcome of placenta previa was premature delivery （ AOR：6.28, 95%CI：1.65-23.82）.Conclusions The uniparas aged over thirty-five are the high-risk groups for placenta previa .So doctors and nurses should identify adverse outcomes of placenta previa among uniparas over thirty-five years old , and take the next step in time .

关 键 词：产妇卫生保健服务 前置胎盘 妊娠结局 高龄初产妇 

分 类 号：R714.2[医药卫生—妇产科学]