二次剖宫产高龄产妇产后出血危险因素的logistic回归分析  

Logistic regression analysis of the risk factors of postpartum hemorrhage in the elderly women with second cesarean section

作　　者：顾双[1] 曲思娆[1] 徐杨[1] GU Shuang;QU Sirao;XU Yang(Department of Obstetrics and Gynecology,the Fourth People′s Hospital of Shenyang,Liaoning Province,Shenyang110031,China)

机构地区：[1]沈阳市第四人民医院妇产科,辽宁沈阳110031

出　　处：《中国医药导报》2020年第30期122-125,共4页China Medical Herald

基　　金：辽宁省卫生计生委科研课题(20160308)。

摘　　要：目的探讨二次剖宫产高龄产妇产后出血危险因素。方法回顾性分析2017年1月—2019年4月于沈阳市第四人民医院行二次剖宫产的480例高龄产妇临床相关资料,根据产妇产后有无出血将其分为出血组(60例)和未出血组(420例)。比较两组一般情况、病史及此次妊娠过程,采用logistic回归分析二次剖宫产高龄产妇产后出血的高危因素。结果两组产妇的流产、胎位、巨大儿、前置胎盘、胎盘植入和胎盘附着位置等比较,差异有统计学意义(P<0.05);两组产妇的产次、引产、合并妊娠期高血压及合并妊娠期糖尿病等比较,差异无统计学意义(P>0.05)。多因素logistic回归分析发现,胎盘附着位置[OR=3.611,95%CI(1.471~8.864),P=0.005]、前置胎盘[OR=5.214,95%CI(2.456~11.069),P<0.001]及胎盘植入[OR=15.213,95%CI(7.245~31.941),P=0.001]是二次剖宫产高龄产妇产后出血的高危因素。结论二次剖宫产高龄产妇产后出血不容忽视,前置胎盘、胎盘植入及胎盘附着位置的二次剖宫产高龄产妇更易发生产后出血,临床需依此采取积极预防措施。Objective To explore the risk factors of postpartum hemorrhage in elderly women with second cesarean section.Methods The clinical data of 480 elderly women who underwent second cesarean section in the Fourth People′s Hospital of Shenyang from January 2017 to April 2019 were analyzed retrospectively.According to whether there was postpartum hemorrhage,they were divided into hemorrhage group(60 cases)and non-hemorrhage group(420 cases).The general situation,medical history and pregnancy process of the two groups were compared,and the high risk factors of postpartum hemorrhage of the elderly women in the second cesarean section were analyzed by logistic regression analysis.Results There were significant differences in abortion,fetal position,macrosomia,placenta previa,placental implantation and placental attachment between two groups(P<0.05).There were no significant differences between two groups in parturient times,induced labor,gestational hypertension and gestational diabetes(P>0.05).Multiple logistic regression analysis showed that the placental attachment position[OR=3.611,95%CI(1.471-8.864),P=0.005],placenta previa[OR=5.214,95%CI(2.456-11.069),P<0.001]and placental implantation[OR=15.213,95%CI(7.245-31.941),P=0.001]were the high risk factors of postpartum hemorrhage in elderly women with second cesarean section.Conclusion The postpartum hemorrhage of the elderly women in the second cesarean section should not be ignored.The elderly women in the second cesarean section with placenta previa,placenta implantation and placental attachment position are more likely to have postpartum hemorrhage.Therefore,the positive preventive measures should be taken in clinical practice.

关 键 词：二次剖宫产 高龄产妇 产后出血 危险因素 LOGISTIC回归分析 

分 类 号：R714[医药卫生—妇产科学]