国内多中心高龄产妇双胎妊娠的产科预后分析  

The obstetric prognostic analysis of advanced maternal age women with twin pregnancy in multiple centers in China

作　　者：李洋洋 尹少尉[1] 刘彩霞[1] Li Yangyang;Yin Shaowei;Liu Caixia(Department of Obstetrics and Gynecology,Shengj ing Hospital,China Medical Univ ersity,Shenyang 110004)

机构地区：[1]中国医科大学附属盛京医院妇产科,沈阳110004

出　　处：《现代妇产科进展》2018年第9期678-681,共4页Progress in Obstetrics and Gynecology

基　　金：国家卫生计生委公益性行业科研专项项目(No:201402006)

摘　　要：目的:探讨高龄产妇与适龄产妇双胎妊娠围产期并发症及结局的差异及其影响因素,进一步指导对高龄产妇双胎妊娠的孕期管理。方法:回顾分析国内九家医院2016年1月至12月收住院的2825例双胎妊娠的临床资料。比较高龄组(≥34岁)与适龄组(18~34岁)的围产期并发症及妊娠结局。Logistic回归分析方法探讨影响双胎妊娠产妇发生孕期母体并发症的相关因素。结果:双胎妊娠产妇中高龄产妇约占19.7%。高龄组发生妊娠期糖尿病、孕期母体并发症[妊娠期糖尿病和(或)妊娠期高血压]的发生率明显高于适龄组(P<0.05);高龄组与适龄组的流产、早产、新生儿窒息等妊娠结局无明显差异(P>0.05)。二分类Logistic回归分析显示,居住地北方、高龄、辅助生殖是危险因素;经产妇是保护因素。结论:高龄产妇双胎妊娠更易发生母体并发症,如妊娠期糖尿病和(或)妊娠期高血压。产妇年龄、受孕方式、产次、居住地是双胎妊娠产妇发生孕期母体并发症的影响因素,尤其是加强高龄、行辅助生殖受孕双胎妊娠产妇的孕期管理,对提高产科预后具有重要意义。Objective:To discuss the perinatal complications and outcome of advanced maternal age women and non-advanced maternal age women with twin pregnancy and factors,so as to direct the pregnancy management of advanced maternal age women in twins.Methods:2825 clinical datas of twin pregnancy of nine hospitals in China were collected from Jan.2016 to Dec.2016.The difference of maternal and perinatal outcomes between the advanced maternal age women(≥35 years)group and non-advanced maternal age women(18<age<35 years)group were analyzed retrospectively,to discuss the relevant factors of maternal complications in twins by Logistic regression analysis.Results:There were about 19.7%advanced maternal age women in twins.The incidence of gestational diabetes mellitus and maternal complications(gestational diabetes mellitus and/or gestational hypertension)in advanced maternal age group was significantly higher than that in non-advanced maternal age women group(P<0.05).There was no significant statistically difference in the incidence of abortion,premature delivery,neonatal asphyxia(P>0.05).The risk factors were north,advanced maternal age and assisted reproductive technology(ART).The protective factor was the pluripara.Conclusion:The advanced maternal age women are more likely to occur maternal complication(gestational diabetes mellitus and/or gestational hypertension).The maternal age,place of abode,assisted reproductive technology(ART),are the influential factors of the maternal complication(gestational diabetes mellitus and/or gestational hypertension)in twins.We should especially strengthen the pregnancy management of advanced maternal age women and twins by ART to improve the perinatal prognosis.

关 键 词：双胎 高龄产妇 辅助生殖 母体并发症 

分 类 号：R714.23[医药卫生—妇产科学]