少数民族地区低龄孕产妇的妊娠结局  

Adolescent pregnancy outcomes in minority areas

作　　者：韦雪萍 周莉[2] 李恒霄 赵瑞芬[2] 范玲 Wei Xueping;Zhou Li;Li Hengxiao;Zhao Ruifen;Fan Ling(Department of Obstetrics and Gynecology,Sanjiang Dong Autonomous County People's Hospital of Liuzhou City,Liuzhou 545500,China;the Second Department of Obstetrics,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China;School of Statistics,Capital University of Economics and Business,Beijing 100070,China;Department of Obstetrics,New Century Women's and Children's Hospital,Beijing 100102,China)

机构地区：[1]柳州市三江侗族自治县人民医院妇产科,545500 [2]首都医科大学附属北京妇产医院产二科,100026 [3]首都经济贸易大学统计学院,100070 [4]北京新世纪妇儿医院产科,100102

出　　处：《中华围产医学杂志》2021年第8期622-626,共5页Chinese Journal of Perinatal Medicine

基　　金：首都卫生发展科研专项(首发2020-2-2113)。

摘　　要：目的分析少数民族地区低龄孕产妇孕期并发症及妊娠结局,初步了解影响低龄孕产妇妊娠结局的相关因素。方法回顾性选取2014年1月1日至2018年12月31日在柳州市三江侗族自治县人民医院住院分娩的年龄<20岁的697例单胎孕产妇,作为低龄组;按1∶4比例选取同期住院分娩、年龄20~25岁的2592例单胎孕产妇,作为适龄组。比较2组孕产妇的一般特征、妊娠并发症及合并症、妊娠结局。采用χ^(2)检验、t检验、非参数检验及二分类多因素logistic回归分析对数据进行统计分析。结果(1)低龄组分娩前体重指数低于适龄组[(24.7±3.4)与(25.1±3.1)kg/m2,t=-2.062,P=0.039],低龄及适龄组中侗族占比分别为48.06%(335/697)和52.04%(1349/2592)。低龄组初中及以下学历的比例高于适龄组[95.41%(665/697)与90.27%(2340/2592),χ^(2)=45.086,P<0.001]。(2)低龄组妊娠合并贫血[24.25%(169/697)与15.20%(394/2592)]、早产[7.17%(50/697)与4.55%(118/2592)]、胎膜早破[13.34%(93/697)与9.10%(237/2592)]、羊水过少[9.76%(68/697)与7.02%(182/2592)]发生率均高于适龄组(χ^(2)值分别为31.683、7.786、10.731及5.848,P值均<0.05)。(3)低龄组剖宫产率[27.26%(190/697)与38.04%(986/2592),χ^(2)=27.791,P<0.001]及新生儿出生体重[(3047.3±453.5)与(3131.0±472.4)g,t=-4.188,P<0.001]均低于适龄组,但会阴侧切率[40.17%(280/697)与8.72%(226/2592)]及入住新生儿重症监护病房的比例[10.76%(75/697)与3.82%(99/2592)]均高于适龄组(χ^(2)值分别为417.439及52.816,P值均<0.001)。(4)二分类多因素logistic回归分析结果示,低龄孕产妇剖宫产(aOR=0.62,95%CI:0.51~0.75)的风险降低,但会阴侧切(aOR=6.20,95%CI:4.99~7.71)及入住新生儿重症监护病房(aOR=2.68,95%CI:1.92~3.75)的风险增加。结论本研究地区孕产妇少数民族居多,其中侗族占比高,且孕产妇文化水平偏低。低龄妊娠的孕产妇发生贫血、早产、胎膜早破等风险较高。因此要加强低龄孕妇围产期保健�Objective To analyze the pregnancy complications and outcomes in adolescent women in minority areas in China and the factors affecting the pregnancy outcomes.Methods This retrospective study enrolled 697 singleton pregnant women who were younger than 20 years old and delivered at Sanjiang Dong Autonomous County People's Hospital of Liuzhou City from January 1,2014,to December 31,2018,as the case group.Meanwhile,2592 cases aged between 20 to 25 years and delivered during the same period were selected as the control group in an allocation ratio of 1∶4.Chi-square test,t test and binary logistic regression were used for comparing the differences of general characteristics,pregnancy complications,comorbidities and pregnancy outcomes between the two groups.Results(1)The body mass index before delivery of the case group was lower than that of the control group[(24.7±3.4)vs(25.1±3.1)kg/m2,t=-2.062,P=0.039].The proportion of Dong minority was accounted for 48.06%(335/697)in the case group and 52.04%(1349/2592)in the control group.The proportion of women with junior school education or lower was higher in the case group than that in the control group[95.41%(665/697)vs 90.27%(2340/2592),χ^(2)=45.086,P<0.001].(2)The case group was noted for higher incidence of anemia[24.25%(169/697)vs 15.20%(394/2592),χ^(2)=31.683],premature delivery[7.17%(50/697)vs 4.55%(118/2592),χ^(2)=7.786],premature rupture of membranes[13.34%(93/697)vs 9.10%(237/2592),χ^(2)=10.731]and oligohydramnios[9.76%(68/697)vs 7.02%(182/2592),χ^(2)=5.848]than the control group(all P<0.05).(3)The incidence of cesarean section[27.26%(190/697)vs 38.04%(986/2592),χ^(2)=27.791,P<0.001]and the neonatal birth weight[(3047.29±453.46)vs(3131.01±472.44)g,t=-4.188,P<0.001]in the case group were lower,but the incidence of episiotomy[40.17%(280/697)vs 8.72%(226/2592)]and the proportion of neonatal intensive care unit admission[10.76%(75/697)vs 3.82%(99/2592)]were higher when comparing to the control group(χ^(2)=417.439 and 52.816,both P<0.001).(4)Multivariate bin

关 键 词：青少年期妊娠 妊娠结局 少数民族 

分 类 号：R714[医药卫生—妇产科学]