二胎阴道分娩产妇产后出血的危险因素分析  

Analysis of risk factors for postpartum hemorrhage in parturients with second child vaginal delivery

作　　者：刘明博[1] 袁源 李光应 杨龙波 周玮[1] 李秀泉[1] LIU Mingbo;YUAN Yuan;LI Guangying;YANG Longbo;ZHOU Wei;LI Xiuquan(Department of Gynecological Pelvic Floor and Oncology,Chongqing Municipal Maternal and Child Health Care Hospital,Chongqing 400013,China)

机构地区：[1]重庆市妇幼保健院妇科盆底与肿瘤科,400013

出　　处：《重庆医学》2021年第9期1511-1513,共3页Chongqing medicine

基　　金：重庆市科委联合中青年医学高端人才项目(2019GDRC013);重庆市技术创新与应用发展专项面上项目(cstc2019jscx-msxmX0209)。

摘　　要：目的探讨在二孩政策下第二胎阴道分娩产妇产后出血的危险因素。方法选择该院2019年1月至2020年6月第二胎阴道分娩的3428例产妇作为研究对象,根据是否发生产后出血,将产妇分为产后出血组(162例)与产后非出血组(3266例),分析产妇的年龄、孕周、孕次、胎盘因素、妊娠期疾病及子宫病变等各类因素与产后出血的相关性,并通过多因素logistic回归分析筛选出独立危险因素。结果通过二元logistic回归分析,胎盘植入(OR=6.73,P<0.01)、胎盘早剥(OR=5.45,P<0.01)、妊娠期中重度贫血(OR=3.23,P<0.01)、子宫病变(OR=2.74,P<0.01)、巨大儿(OR=2.59,P<0.01)和妊娠期糖尿病(GDM,OR=1.66,P<0.01)为产后出血的独立危险因素。结论对于二胎阴道分娩产妇,为预防产后出血应警惕高危因素。Objective To explore the risk factors of postpartum hemorrhage in the second vaginal delivery under the two-child policy.Methods A total of 3428 parturients with second child vaginal delivery in this hospital from January 2019 to June 2020 were selected as the research subjects and divided into the postpartum hemorrhage group(162 cases)and non-postpartum hemorrhage group(3266 cases)according to whether postpartum hemorrhage occurring,and the age of the parturients was analyzed.The correlation between the various factors such as gestational age,pregnant weeks,gravidity,placental factors,pregnancy diseases and uterine lesions with postpartum hemorrhage,and the independent risk factors were screened out through multivariate logistic regression analysis.Results Through the binary logistic regression analysis,placental implantation(OR=6.73,P<0.01),placental abruption(OR=5.45,P<0.01),moderate to severe anemia during pregnancy(OR=3.23,P<0.01),uterine lesions(OR=2.74,P<0.01),macrosomia(OR=2.59,P<0.01)and gestational diabetes mellitus(GDM,OR=1.66,P<0.01)were the independent risk factors for postpartum hemorrhage.Conclusion Preventing postpartum hemorrhage in parturients with second vaginal delivery should be vigilant in high-risk factors.

关 键 词：二孩 阴道分娩 产后出血 危险因素 回归分析 

分 类 号：R714.461[医药卫生—妇产科学]