复发性自然流产的影响因素分析——来自于美国的一项调查  

Study on influence factors of recurrent spontaneous abortion

作　　者：叶霞燕 叶笑梅 朱波 沈哓露 郑加永 

机构地区：[1]浙江省温州市人民医院妇产科,350000

出　　处：《中国计划生育学杂志》2016年第6期372-376,共5页Chinese Journal of Family Planning

摘　　要：目的：探讨复发性自然流产（RSA）的常见影响因素,为其防治提供依据。方法：使用2011~2013年美国疾病预防和控制中心（CDC）开展的一项有代表性的全国横断面调查的数据;调查对象是生活在美国的15~44岁女性,调查内容包括了与妊娠、避孕、不育、性生活有关的行为。选取其中1706人进行分析,其中RSA组201人,对照组1505人。结果：多因素logistic分析结果显示,年龄、曾有排卵或月经问题、曾患性传播疾病（STD）和人工流产次数与RSA存在相关。年龄≥40岁的女性发生RSA的风险是年龄〈20岁的女性的4.06倍（OR=4.06,95%CI：1.117~14.062）。有过1次人工流产的女性发生RSA的风险是没有人工流产的3.28倍（OR=3.277,95%CI：1.798~5.972）。患有排卵或月经问题、性传播疾病更容易发生RSA,OR值分别为1.647（95%CI：1.002~2.707）和2.299（95%CI：1.029~5.133）。结论：年龄≥40岁的孕妇是RSA的高危人群。应积极治疗STD等相关疾病、避免多次人工流产,以降低RSA的发生。Objective： To explore the common influence factors of recurrent spontaneous abortion （RSA）, and to pro- vide evidence for preventing and treating RSA. Method= The included data was came from the database of the repre sentative national cross sectional study carried out by CDC（Centers for Disease Control and Prevention）of the United States from 2011 to 2013, which had focused on America women at 15 to 44 years old. The contents of the study were related to pregnancy, contraception, infertility and sex. The information of 1706 women was analyzed. 201women were in RSA group and 1505 women were in control group. Result： The logistic regression analysis showed that RSA was relevant to women age, ovulation and menstruation problem, history of sexually transmitted diseases, and the number of abortion. The risk of RSA in women at older age（〉 40 years old）was 4.062 time of that of younger women（〈20 years old）（OR=4.062,95%CI：11174-14.062）. The risk of RSA of women with at least once abortion was 3.28 time of that of women without abortion（OR=3.277,95%CI： 1.798-5.972）. Women with ovulation or menstrual diseases had higher risk of RSA （OR=1.647,95%CI：1.002-2.707 and OR=2.299, 95%CI=1.029-5.133）. Conclusion： Pregnant women over 40 years old had higher risk of RSA. In order to reduce the occurrence of RSA, sexually transmitted disea- ses and other related diseases should be actively treated, and repeated abortion should be avoided.

关 键 词：复发性自然流产 影响因素 人工流产 生殖道感染 美国 

分 类 号：R714.21[医药卫生—妇产科学]