29227例高危妊娠相关因素分析  

Analysis of related factors of high-risk pregnancy in 29227 cases

作　　者：钟赋真[1] 赵温[1] 张颖[1] ZHONG Fuzhen;ZHAO Wen;ZHANG Ying(Haidian Maternal and Child Health Hospital,Beijing 100080,China)

机构地区：[1]北京市海淀区妇幼保健院,北京100080

出　　处：《中国妇幼健康研究》2021年第1期44-48,共5页Chinese Journal of Woman and Child Health Research

摘　　要：目的了解北京市海淀区产科医院高危妊娠的发生及病因分布等,为产科质量的管理提供依据,控制孕产妇死亡率。方法通过北京市妇幼信息系统《北京市孕产妇分娩个案登记》导出2017年10月1日至2019年9月30日的分娩个案,对海淀区29227例高危孕产妇的分娩情况开展调查。结果高危妊娠中的前五位高危因素顺位为高龄、剖宫产再孕、妊娠糖尿病、甲状腺疾病和贫血。妊娠糖尿病与非妊娠糖尿病、甲状腺疾病与非甲状腺疾病、剖宫产再孕与非剖宫产再孕的<35岁、35~40岁、>40岁年龄分布差异均有统计学意义(χ^2=6.062~2438.338,均P<0.05)。除甲状腺疾病与非甲状腺疾病在1000~2000mL产后出血量分布差异无统计学意义,妊娠糖尿病与非妊娠糖尿病、甲状腺疾病与非甲状腺疾病、剖宫产再孕与非剖宫产再孕的<1000mL、1000~2000mL、>2000mL产后出血量分布差异均有统计学意义(χ^2=0.043~955.657,均P<0.05)。除甲状腺疾病与非甲状腺疾病在产钳助产、剖宫产分布差异均无统计学意义,妊娠糖尿病与非妊娠糖尿病、甲状腺疾病与非甲状腺疾病、剖宫产再孕与非剖宫产再孕的自然产、产钳助产、剖宫产分布差异均有统计学意义(χ^2=4.274~12184.144,均P<0.05)。孕产妇的妊娠糖尿病与非妊娠糖尿病的孕周<37(周)、产后2小时出血、活产、新生儿出生体重<2500g和>4000g分布差异均有统计学意义(χ^2=11.917~30369.873,均P<0.05);甲状腺疾病与非甲状腺疾病的产后2小时出血分布差异有统计学意义(χ^2=36.593,P<0.05);剖宫产再孕与非剖宫产再孕的孕周<37(周)、产后2小时出血、死胎、活产、新生儿出生体重<2500g和>4000g分布差异均有统计学意义(χ^2=5.955~3556.795,均P<0.05)。结论(1)全面放开"二孩"政策实施后,高龄、剖宫产再孕成为主要的妊娠高危因素;(2)高危妊娠的结局明显差于非高危组,必须重视高危孕产妇的管理和监测�Objective To understand the occurrence and the distribution of causes of high-risk pregnancy in obstetric hospitals of Haidian District of Beijing,so as to provide basis for obstetric quality management and control of maternal mortality.Methods The delivery cases from October 1,2017 to September 30,2019 were exported from"Beijing maternal and child delivery case registration"reported by Beijing Maternal and Child Information System,and the delivery situation of 29227 high-risk pregnant women in Haidian District was investigated.Results The top five causes of high-risk pregnancy were advanced age,repregnancy after cesarean section,pregnancy with diabetes mellitus,thyroid disease or anemia.There were significant differences in the distribution of maternal age among<35 years,35-40 years and>40 years between gestational diabetes and non-gestational diabetes,thyroid disease and non-thyroid disease,repregnancy after cesarean section and repregnancy after non-cesarean section(χ^2 values ranged from 6.062 to 2438.338,all P<0.05).Except for no significant difference of the distribution of postpartum bleeding ranged from 1000 to 2000 ml between thyroid disease and non-thyroid disease,the differences of distribution of postpartum bleeding less than 1000 ml,ranged from 1000 to 2000 ml or more than 200 ml between gestational diabetes and non-gestational diabetes,thyroid disease and non-thyroid disease,repregnancy after cesarean section and repregnancy after non-cesarean section were all significant(χ^2 values ranged from 0.043 to 955.657,all P<0.05).Except for no significant difference of the distribution of forceps midwifery and cesarean section between thyroid disease and non-thyroid disease,there were significant differences in the distribution of spontaneous labor,forceps midwifery and cesarean section between gestational diabetes and non-gestational diabetes,thyroid disease and non-thyroid disease,repregnancy after cesarean section and repregnancy after non-cesarean section(χ^2 values ranged from 4.274 to 184.144,all

关 键 词：高危妊娠 妊娠糖尿病 妊娠合并甲状腺疾病 剖宫产再孕 

分 类 号：R714.2[医药卫生—妇产科学]