2013—2017年河北省异常胎位流行病学特点及危险因素分析  

Analysis of the epidemiological characteristics and risk factors of abnormal presentation in Hebei,2013-2017

作　　者：王朔 贾璐 廖芳 王洪霞 王莉[1] WANG Shuo;JIA Lu;LIAO fang;WANG Hong-xia;WANG Li(Department of Obstetries and Gynecology,Hebei General Hospital,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省人民医院妇产科,河北石家庄050000 [2]华北理工大学研究生院,河北唐山063000

出　　处：《现代预防医学》2021年第3期451-455,共5页Modern Preventive Medicine

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

摘　　要：目的了解河北省异常胎位流行病学特点和发病危险因素。方法收集2013-01-01至2017-12-31河北省22所监测点(医院)的孕产妇分娩的相关数据,分析异常胎位流行病学特佂,应用多因素logistic回归分析异常胎位发病的影响因素。结果共有产妇237 663例,异常胎位患者7 394例,异常胎位患病率为3.1%。石家庄市产妇异常胎位发生率3.7%,秦皇岛市为2.1%。城市医院分娩的产妇异常胎位发病率高于乡镇医院(χ~2=564.010,P <0.05)。三级医院分娩的产妇异常胎位的患病率高于二级医院、一级医院(χ~2=811.314,P <0.05)。≥35岁产妇异常胎位发生率高于其他年龄的产妇(χ~2=61.167,P <0.05)。产妇异常胎位发生率冬季为3.3%,夏季为2.9%。产妇异常胎位剖宫产率(86.5%)、新生儿死亡率(1.4%)、死胎率(3.9%)及新生儿窒息率(4.6%)均高于正常胎位产妇。多因素logistic回归分析结果显示季节、年龄、孕周、初产情况、瘢痕子宫、妊娠合并高血压、新生儿体重及新生儿性别均为异常胎位的影响因素。结论应对不同地区采取个性化实施措施,加强对高危人群监管护理,切实降低异常胎位的发生率,改善不良围产结局。Objective To investigate the prevalence,epidemiological characteristics and risk factors of abnormal fetal position in Hebei Province. Methods Relevant data on maternal delivery at 22 monitoring points( hospitals) in Hebei Province from January 1,2013 to December 31,2017 were collected. Epidemiological characteristics of abnormal fetal position were analyzed. Multivariate Logistic Regression was used to analyze the influencing factors of abnormal presentation. Results 237663 maternal cases were included. The overall prevalence of abnormal fetal position was 3. 1%( 7 394/237 663). From a city-specific perspective,the prevalence of abnormal fetal position in Zhangjiakou City and Qinhuangdao City was 3. 7% and2. 1%,respectively. In the view of the location of hospital for childbirth,the incidence of abnormal fetal position was higher in urban hospitals compared with rural hospitals( χ2= 564. 010,P < 0. 05). From the point of view of the level of hospitals,the prevalence of abnormal fetal position increased successively in primary,secondary and tertiary hospitals( χ2= 811. 314,P <0. 05). Age group of 35 possessed the highest prevalence of abnormal fetal position( χ2= 61. 167,P < 0. 05). In terms of onset season,the incidence of abnormal fetal position in winter and summer was 3. 3% and 2. 9%,respectively. The incidences of cesarean section( 86. 5%),neonatal mortality( 1. 4%),stillbirth( 3. 9%),and neonatal asphyxia( 4. 6%)were higher than those of normal fetuses. The results of multivariate logistic regression analysis showed that season,gestational age,primiparity situation,scarred uterus,gestational hypertension,newborn weight and newborn gender were all factors influencing the prevalence of abnormal fetal position. Conclusion It is necessary to take individualized implementation measures in different regions,strengthen supervision and care of high-risk groups,effectively reduce the incidence of abnormal fetal positions,and improve the poor perinatal outcomes.

关 键 词：异常胎位 危险因素 流行病学特点 妊娠 

分 类 号：R172[医药卫生—妇幼卫生保健] R181.3[医药卫生—公共卫生与预防医学]