不良妊娠结局危险因素的巢式病例对照研究  

Risk factors of adverse pregnancy outcomes based on a nested case-control study

作　　者：车洋洋 郭艳巍[2] 王志宏[2] 毛淑芳[1] 

机构地区：[1]承德医学院预防医学教研室,河北承德067000 [2]承德医学院附属医院产科,河北承德067000

出　　处：《中国妇幼保健》2017年第2期230-233,共4页Maternal and Child Health Care of China

基　　金：河北省人口与计划生育委员会计划项目(2008-B06)

摘　　要：目的探讨影响不良妊娠结局的危险因素,为预防不良妊娠结局的发生提供科学依据。方法选取2014年9月-2015年3月在该院产科门诊就诊并建档的孕妇310例为研究对象,采用巢式病例对照研究,将孕妇队列中确诊为不良妊娠结局的76例孕妇作为病例组,将妊娠结局正常的234例孕妇作为对照组,分析影响不良妊娠结局发生的相关因素。结果不良妊娠结局的发生率为24.5%。Logistic回归分析显示,流产史(OR=1.828,95%CI:1.051~3.180)、孕早期保胎史(OR=1.773,95%CI:1.021~3.080)是不良妊娠结局的危险因素;剖宫产史(OR=0.219,95%CI:0.073~0.655)是不良妊娠结局的保护因素;与孕前体重指数过低者相比,孕前体重指数正常(OR=0.113,95%CI:0.026~0.501)、超重(OR=0.171,95%CI:0.045~0.654)和肥胖(OR=0.188,95%CI:0.044~0.804)均是不良妊娠结局的保护因素。结论流产史、孕早期保胎史、剖宫产史、孕前体重指数与不良妊娠结局有关,应加强育龄妇女的健康教育,促进其采取有效的避孕措施及养成健康的行为生活方式,预防不良妊娠结局的发生。Objective To explore the risk factors of adverse pregnancy outcomes,provide a scientific basis for preventing adverse pregnancy outcomes. Methods A total of 310 pregnant women visited Obstetric Outpatient and set up files in the hospital from September 2014 to March 2015,then a nested case-control study was performed,all the pregnant women were divided into case group（ including 76 pregnant women having adverse pregnancy outcomes） and control group（ including 234 pregnant women having normal pregnancy outcomes）. The related influencing factors of adverse pregnancy outcomes were analyzed. Results The incidence rate of adverse pregnancy outcomes was 24. 5%.Logistic regression analysis showed that abortion history（ OR = 1. 828,95% CI： 1. 051-3. 180） and fetus protection history during the first trimester of pregnancy（ OR = 1. 773,95% CI： 1. 021-3. 080） were risk factors of adverse pregnancy outcomes. The history of cesarean section（ OR=0. 219,95% CI： 0. 073-0. 655） was the protective factor of adverse pregnancy outcomes. Compared with the low prepregnancy body mass index,normal prepregnancy body mass index（ OR = 0. 113,95% CI： 0. 026-0. 501）,overweight（ OR = 0. 171,95% CI： 0. 045-0. 654）and obesity（ OR = 0. 188,95% CI： 0. 044-0. 804） were the protective factors of adverse pregnancy outcomes. Conclusion Abortion history,fetus protection history during the first trimester of pregnancy,the history of cesarean section and the prepregnancy body mass index are correlated with adverse pregnancy outcomes. To prevent the occurrence of adverse pregnancy outcomes,we should strengthen health education of women of childbearing age,promote them to take effective contraceptive measures and develop healthy life styles.

关 键 词：不良妊娠结局 危险因素 巢式病例对照研究 

分 类 号：R714.12[医药卫生—妇产科学]