胎位对妊娠结局影响的横断面研究  

A cross-sectional study of the effects of fetal position on pregnancy outcomes

作　　者：王朔 贾璐 廖芳 石子佳 袁会卿 王莉[1] WANG Shuo;JIA Lu;LIAO Fang;SHI Zijia;YUAN Huiqing;WANG Li(Department of Obstetrics and Gynecology,Hebei General Hospital Affiliated to North China University of Science and Technology,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院产科,石家庄050051 [2]华北理工大学研究生院,河北唐山063000 [3]河北医科大学研究生院,石家庄050017

出　　处：《实用医学杂志》2020年第14期1997-2002,共6页The Journal of Practical Medicine

基　　金：河北省科技厅重点项目(编号:18397779D);河北省科技厅引智项目(编号:2019YX013A)。

摘　　要：目的收集2013-2017年河北省产妇异常胎位的发生情况,并探讨其影响因素和妊娠结局。方法通过河北省妇幼保健中心产妇监测信息管理系统(网络直报),收集2013年1月1日至2017年12月31日在河北省各地22个监测点(医院)共273 977例住院产妇的资料信息,分析2013-2017年河北省产妇异常胎位发生情况,并分析其相关影响因素和妊娠结局。结果河北省273 977例产妇中,异常胎位者8 176例,患病率为3.0%,其中臀位7 844例(2.8%)、横位195例(0.1%)、混合位137例(0.1%)。不同年龄、产前检查次数、分娩地点、孕次、产次、以及是否有剖宫产史和孕期并发症的产妇异常胎位发生率差异均有统计学意义(均P <0.05)。多因素Logistic回归分析结果,臀位、横位、混合位是出现剖宫产分娩、新生儿1 min Apgar评分≤7的影响因素(P <0.01);臀位,横位是出现早产儿、低出生体重儿、死胎的影响因素(P <0.01);横位是出现产妇产后出血的影响因素(P <0.01)。结论异常胎位患病率在≥35岁产妇中发生率较高,建议适度孕育,针对不同地区,尤其是高危人群采取预防措施,加强监测,对改善不良围产结局具有重要意义。Objective The aim of this study was to investigate the abnormal fetal position in maternalwomen in Hebei Province from 2013 to 2017 and explore the influencing factors and pregnancy outcomes.Methods Data on 273977 maternal women from 22 monitoring sites(hospital)in Hebei Province were collected from 2013-01-01 to 2017-12-31 and gathered through the Maternal and Child Health Monitoring Information ManagementSystem of Hebei Province(Network Direct Report). The abnormal fetal position,and the factors influencing themwere analyzed.ResultAmong all the maternal women,the overall prevalence rate of abnormal fetal position was3.0% and the prevalence rate was 2.8%(the number of the patients:7844)for breech presentation,0.1%(195)for shoulder presentation,and 0.1%(137)for compound presentation,respectively. The prevalence rate of abnor-mal fetal position differed significantly in age,the number of prenatal examinations,pregnancy number.number oflabor,place of residence,a history of previous cesarean section and complications during pregnancy in the mater-nal(all P < 0.05). Multivariate Logistic regression analysis showed that breech presentation,shoulder presenta-tion,and compound presentation were the factors influencing cesarean delivery and neonatal 1 min Apgar score 7(P < 0.01);breech presentation and shoulder presentation were the factors influencing premature infants,lowbirth weight infants and stillbirths(P < 0.01);shoulder presentation were the factors influencing postpartum hem-orrhage(P < 0.01).ConclusionAbnormal fetal position seemed to be associated with a moderate increasing riskof age. It was seen higher in those population older than 35,which suggested that appropriate inoculation programsshould be taken in different regions especially on high-risk groups. Health education on related disease was of greatsignificance for improving the prenatal outcome.

关 键 词：异常胎位 妊娠结局 臀位 横位 围产儿 

分 类 号：R714.2[医药卫生—妇产科学]