河北省孕产妇前置胎盘流行病学特点和危险因素分析  

Epidemiological characteristics and risk factors of placenta previa in Hebei Province

作　　者：李思思 郭广丽 于璨 赵姗[1] 段雅[1] 李季滨[1] 董姗姗 王莉[1] LI Sisi;GUO Guang⁃li;YU Can;ZHAO Shan;DUAN Ya;LI Jibin;DONG Shanshan;WANG Li(Department of Obstetrics and Gyne⁃cology,Hebei General Hospital,Shijiazhuang 050057,China)

机构地区：[1]河北省人民医院妇产科,石家庄050057 [2]华北理工大学研究生院,河北唐山063000 [3]河北北方学院研究生院,河北张家口075000

出　　处：《实用医学杂志》2020年第2期249-253,共5页The Journal of Practical Medicine

基　　金：河北省科技厅重点项目(编号：18397779D)

摘　　要：目的了解河北省前置胎盘流行病学特点和危险因素。方法收集河北省妇幼监测信息管理系统2013-2017年河北省22所监测医院的孕产妇资料,调查前置胎盘的三间分布、母儿结局和危险因素。结果267834例孕产妇中,前置胎盘1221例(4.6‰);患病率随年龄增高而升高,且城市高于县乡,一级、二级、三级医院的患病率逐渐升高;前置胎盘组新生儿不良结局均高于非前置胎盘组;多因素回归分析显示以下因素是前置胎盘的独立危险因素:产次(OR=2.84,95%CI:1.77~4.56);孕次(OR=2.59,95%CI:2.01~3.34);剖宫产史(OR=1.90,95%CI:1.64~2.21);贫血(OR=1.62,95%CI:1.44~1.83);慢性高血压(OR:1.45,95%CI:1.01~2.08)、医院等级(OR=5.36,95%CI:3.03~9.47)、省市(OR=4.56,95%CI:3.49~5.97)。结论适时孕育、避免危险因素,以降低前置胎盘发生率,从而降低母儿不良结局。Objective To investigate the epidemiological characteristics and risk factors of placenta previa in Hebei province.Methods Select 267834 cases from 22 critical maternal surveillance hospitals in Hebei prov⁃ince from January 1,2013 to December 31 in 2017,to investigate the distribution of placenta previa,maternal and infant outcomes and risk factors.Results Among 267,834 pregnant women,1221 cases(4.6‰)had placenta previa.The prevalence increased with age,the prevalence of the hospitals in the large cities was significantly higher than that of the small ones,and the prevalence of primary hospitals,secondary hospitals and tertiary hospitals increased gradually.The preterm delivery rate,cesarean section rate,postpartum hemorrhage rate,hysterectomy rate,mortality rate,neonatal asphyxia rate,neonatal mortality rate,stillbirth rate were all higher in the group with placenta previa than in the group without placenta previa.Multivariate regression analysis showed that the following factors were independent risk factors for gestational diabetes:Parity(OR=2.84,95%CI:1.77~4.56),Pregnancy(OR=2.59,95%CI:2.01~3.34),History of cesarean section(OR=1.90,95%CI:1.64~2.21),anemia(OR=1.62,95%CI:1.44~1.83),chronic hypertension(OR=1.45,95%CI:1.01~2.08),hospital grade(OR=5.36,95%CI:3.03~9.47),city(OR=4.56,95%CI:3.49~5.97).Conclusions Timely gestation and avoiding risk factors to reduce the incidence of placenta previa,thereby reducing the adverse outcomes of mother and child.

关 键 词：前置胎盘 流行病学特点 危险因素 

分 类 号：R714[医药卫生—妇产科学]