抗磷脂综合征合并妊娠干预时机对妊娠结局的影响分析  

Effect of intervention timing on obstetric outcomes in APS with pregnancy

作　　者：宋文惠[1,2] 杨孜[1] 郭宏霞[1] 王海玲[1] 

机构地区：[1]北京大学第三医院妇产科,100191 [2]河北省石家庄第四医院

出　　处：《中国妇产科临床杂志》2016年第3期200-203,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：国家自然科学基金资助项目(81370723);北京市自然科学基金项目(7132215)

摘　　要：目的分析抗磷脂综合征（antiphospholipid syndrome,APS）合并妊娠不同干预时机对产科和围产结局的影响,探讨APS早期干预对于降低产科并发症和改善母儿结局的作用。方法对2006年1月至2014年12月北京大学第三医院收治的127例原发性抗磷脂综合征合并单胎妊娠并分娩的孕妇的临床资料进行回顾性分析,按照围孕期和孕期针对APS不同的干预时机分为未干预组、孕前干预组、〈孕14周干预组及≥孕14周干预组,分析妊娠期APS干预时机对妊娠结局的影响。结果 APS未干预组早发子痫前期的发生率显著高于其他各时期干预组（P〈0.008）;孕早期干预组早发子痫前期的发生率显著低于孕14周后干预组（P〈0.008）。APS未干预组和≥孕14周干预组早发子痫前期、胎儿生长受限、羊水过少、新生儿窒息、血栓的发生率均高于孕前干预组和〈孕14周干预组,早发子痫前期和胎儿生长受限的发病率在APS不同干预时机组中差异有统计学意义（P〈0.001,P〈0.05）。孕〈14周干预与37周之后分娩呈正相关（OR=5.515,95%CI：1.876~16.215,P=0.027）。结论早期排查和干预APS有利于改善APS妊娠者的产科和围产结局。Objective This study was to evaluate the effect of the intervention timing on the obstetric outcomes in pregnant women with primary antiphospholipid Syndrome（APS）.Methods One hundred and twenty-seven women of singleton pregnancy with APS were included in this retrospective study in Peking University Third Hospital from Jan.2006 to Dec.2014.According to intervention timing they were divided into groups as non-intervention group,pre-pregnancy intervention group,intervention before 14 gestational week and after 14 gestationweek group.The effects of the intervention timing on pregnancy outcomes were analyzed.Results The incidence of early-onset pre-eclampsia was significantly higher in non-intervention group than the other intervention groups（P〈0.008）.Rate of early onset pre-eclampsia was significantly lower in early intervention groups than that in intervention after 14gestation-week group（P 0.008）.The occurrence of early onset preeclampsia,fetal growth restriction,oligohydramnios,neonatal asphyxia and thrombosis were higher in non-intervention group and after 14gestation-week intervention group than that in the other two groups.The incidence of early-onset preeclampsia and fetal growth restriction were significant different at different interventions time（P 0.001 and P〈0.05）.There was a positive correlation between termination of pregnancy after 37 weeks and intervention before 14gestation-week（OR=5.515,95% CI：1.876~16.215,P=0.027）.Conclusion Strengthening early screening and intervention for APS will help to improve obstetric and perinatal outcomes in APS with pregnancy.

关 键 词：抗磷脂综合征 妊娠结局 早发子痫前期 干预 

分 类 号：R714.25[医药卫生—妇产科学]