高龄孕妇合并妊娠期高血压疾病妊娠结局的临床分析  

Clinical analysis the pregnant outcomes of women of advanced age with hypertensive disorders complicating pregnancy

作　　者：聂晓露[1] 付帅[1] 刘玉昆[1] 张建平[1] 陈慧[1] Nie Xiaolu;Fu Shuai;Liu Yukun;Zhang Jianping;Chen Hui(Department of Obstetrics and gynecology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,Guangdong,China)

机构地区：[1]中山大学孙逸仙纪念医院妇产科,广州510120

出　　处：《中华产科急救电子杂志》2020年第2期101-105,共5页Chinese Journal of Obstetric Emergency（Electronic Edition）

基　　金：广东省自然科学基金自由申请项目(2014A030313079);中山大学5010项目(2012006);广东省科技厅公益研究与能力建设专项资金(2017A020214018)。

摘　　要：目的分析高龄孕妇合并妊娠期高血压疾病的临床特征,为改善其妊娠结局提供临床依据。方法采用回顾性研究方法,收集和分析2018年1月至2018年12月在中山大学孙逸仙纪念医院住院分娩妊娠期高血压疾病71例患者的临床资料,其中年龄≥35周岁24例(高龄组),年龄<35周岁47例(对照组),比较两组患者发病孕周、入院孕周、分娩孕周、妊娠合并症或并发症、分娩孕周、新生儿出生体重、新生儿窒息、新生儿呼吸窘迫综合征发生情况;正态分布资料使用t检验,非正态分布资料,使用Mann-Whitney U法进行统计分析,计数资料采用X2检验。结果高龄组与对照组相比较,尿素(5.49±2.44)mmol/L vs(4.40±1.46)mmol/L,t=-2.342)、入院孕周(34.86周vs 37.14周,t=-2.095)、分娩孕周(36.07周vs 37.43周,t=-2.564)、剖宫产率(70.83%vs 42.55%,X2=5.092)、顺产率(8.33%vs 46.81%,X2=10.510)、引产率(16.67%vs 2.13%,X2=5.130),差异有统计学意义(P<0.05)。两组新生儿体重(2680 g vs 2960 g,Z=-1.876)、新生儿窒息率(8.33%vs 8.51%,X2=0.001)、新生儿呼吸窘迫综合征率(4.17%vs 14.89%,X2=0.913),差异无统计学意义(P>0.05)。结论高龄患者合并妊娠期高血压疾病,与35岁以下孕妇发生妊娠期高血压疾病相比,临床特征为发病更早、肾脏功能损害更严重,终止妊娠孕周较早,早产率、剖宫产率升高,顺产率降低。对于高龄孕妇,应在妊娠过程中给予比普通孕妇更严密的母胎监测。Objective To analyze the clinical characteristics of pregnant women of advanced age with hypertensive disorders complicating pregnancy,and to provide the clinical basis for improving the pregnancy outcome.Methods A retrospective study was used to collect and analyze the clinical data of 71 cases of hypertensive disorder complicating pregnancy during delivery in Sun Yat-sen Memorial Hospital of Sun Yat-sen University from January 2018 to December 2018.They were divided into two groups according to the age;24 cases with age≥35 years old were in the advanced maternal age group and 47 cases with age<35 years old were in the control group.Compare gestational weeks of onset,gestational weeks of admission,gestational weeks of delivery,complications of pregnancy,termination of pregnancy,neonatal weight,the rate of neonatal asphyxia and infant respiratory distress syndrome between the two groups.Student t-test was preformed to normal distributive data and Mann-Whitney U test was used to non-normally distributed variables.Chi-square test was used in count data.Results There were significant differences in urea nitrogen(5.49±2.44 mmol/L vs 4.40±1.46 mmol/L,t=-2.342),gestational age at admission(34.86 vs 37.14,t=-2.095),gestational age at delivery(36.07 vs 37.43,t=-2.564),the rate of Cesarean(70.83%vs 42.55%,X2=5.0920),vaginal delivery(8.33%vs 46.81%,X2=10.510)and induction of labor(16.67%vs 2.13%,X2=5.130)between the advanced maternal age group and the control group were statistically significant(P<0.05),while there was no significant difference in the neonatal weight(2680 g vs 2960 g,Z=-1.876),the rate of neonatal asphyxia(8.33%vs 8.51%,X2=0.001)and infant respiratory distress syndrome(4.17%vs 14.89%,X2=0.913)among two groups(P>0.05).Conclusions The clinical features of women of advanced age with hypertensive disorders complicating pregnancy were earlier onset,more serious renal function damage,earlier pregnancy termination,higher rate of premature delivery and Cesarean,lower rate of vaginal delivery.More closely monit

关 键 词：高龄 妊娠期高血压疾病 妊娠结局 

分 类 号：R71[医药卫生—妇产科学]