经阴分娩经产妇生育间隔对妊娠结局的影响  

Effects of interpregancy interval on pregnancy outcomes in multiparas with vaginal delivery

作　　者：赵艳[1] 赵扬玉[1] 张研红[1] 刘鹭燕[1] 倪胜莲[1] 卢? Zhao Yan;Zhao Yangyu;Zhang Yanhong;Liu Luyan;Ni Shenglian;Lu Jie(Department of Gynaecology and Obstetrics, Peking University Third Hospital, Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科,北京100191

出　　处：《中华现代护理杂志》2019年第6期694-697,共4页Chinese Journal of Modern Nursing

基　　金：国家医药卫生科技发展研究中心重点研发计划项目(2016YFC1000400).

摘　　要：目的探讨经阴分娩经产妇的生育间隔对妊娠结局的影响,为有再生育计划的妇女提供孕前咨询及临床指导提供科学依据。方法采用回顾性分析的方法,选取2016 年1—12 月在北京大学第三医院产科住院经阴道分娩的所有经产妇为研究对象。根据生育间隔长短分为3组,第1组为生育间隔0~35个月,共134例;第2组为生育间隔36~71个月,共274例;第3组为生育间隔≥72个月,共256例。分析生育间隔与妊娠期并发症、合并症、产程时间和产时出血及围产儿结局等妊娠结局的关系。应用 SPSS 22.0软件对数据进行统计学分析。结果胎膜早破第1 组18 例,第2 组37 例,第3 组58 例;子宫肌瘤第1 组7 例,第2 组17 例,第3 组31 例;不同生育间隔组间胎膜早破和子宫肌瘤发生率比较差异有统计学意义(χ2 值分别为9.379、8.143;P< 0.05);校正母亲年龄等混淆因素后,胎膜早破和子宫肌瘤患病风险自生育间隔72个月后升高(OR值分别为1.888、2.519;P<0.05)。结论较长的生育间隔与胎膜早破和子宫肌瘤发生风险增加相关,应针对较长生育间隔产妇的特点,加强孕前和孕期教育,保证母婴健康。Objective To explore the effects of interpregancy interval( IPI) on pregnancy outcomes in multiparas with vaginal delivery and to provide a scientific reference for preconception counseling and clinical guidance for women who planned to bear another child. Methods All the multiparas who labored via vaginal delivery in Peking University Third Hospital between January and December 2016 were selected in this retrospective analysis. The multiparas were divided into three groups based on their IPI. The IPI of the first group was 0-35 months( n=134);The IPI of the second group was 36-71 months( n=274);and the IPI of the third group was≥72 months(n=256). The relationship between IPI and pregnancy complications, comorbidities, labor time, hemorrhage and perinatal outcome was analyzed. SPSS 22.0 was used for statistical analysis. Results Premature rupture of membranes( PROM) was found in 18 multiparas in the first group, 37 in the second group and 58 in the third group;uterine fibroid was found in 7 multiparas in the first group, 17 in the second group and 31 in the third group;there was statistically significant difference in PROM and the incidence rate of uterine fibroid between the groups with different IPI(χ2=9.379,8.143;P < 0.05);when confounding factors such as the mothers' age were adjusted, the risk of PROM and uterine fibroid continued to rise since the 72nd month of IPI( OR=1.888,2.519;P<0.05). Conclusions Longer IPI is associated with the increase in the risk of PROM and uterine fibroid. Pre-pregnancy and pregnancy education should be enhanced to ensure maternal and child health according to the characteristics of multiparas with longer IPI.

关 键 词：妊娠 胎膜早破 经阴分娩 经产妇 生育间隔期 结局 子宫肌瘤 

分 类 号：R714[医药卫生—妇产科学]