高龄孕产妇临床特征及孕检对妊娠风险的影响  

Clinical characteristics of pregnant woman in advanced maternal age and effect of pregnancy tests for pregnancy risks

作　　者：马聆桦 李江恒 钟柳育 黄永全[2] 朱茂灵 MA Linghua;LI Jiangheng;ZHONG Liuyu;HUANG Yongquan;ZHU Maoling(Department of Pregnancy Health Care,Nanning City Maternal and Child Health Care Hospital Affiliated to Guangxi Medical University,Nanning,Guangxi,530022;Department of Maternal and Child Health and Family Planning Services,Nanning City Maternal and Child Health Care Hospital Affiliated to Guangxi Medical University,Nanning,Guangxi,530022)

机构地区：[1]广西医科大学附属南宁市妇幼保健院孕产保健部,广西南宁530022 [2]广西医科大学附属南宁市妇幼保健院妇幼健康和计划生育服务部,广西南宁530022

出　　处：《实用临床医药杂志》2022年第9期50-53,58,共5页Journal of Clinical Medicine in Practice

基　　金：广西壮族自治区南宁市科学研究与技术开发计划项目(20183038-3)。

摘　　要：目的探讨高龄孕产妇临床特征及高龄、孕检对妊娠合并症或并发症的影响。方法选取南宁市6个城区111804例孕产妇,按照年龄划分为低龄组(年龄<35岁)和高龄组(年龄≥35岁),回顾性分析孕产妇临床特征、妊娠合并症或并发症等资料。结果高龄组孕早期检查和孕检次数≥5次者占比低于低龄组,而孕次≥3次、经产、剖宫产史、人工或自然流产≥3次、辅助生殖技术受孕、多胎、孕期接触可疑致畸物质、重度高危妊娠者占比高于低龄组,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,高龄是妊娠期高血压、妊娠期糖尿病、甲状腺功能亢进或低下、贫血、卵巢或子宫肿瘤、子痫前期、胎盘早剥、前置胎盘、胎膜早破、胎位异常、产后出血、羊水过多的危险因素(P<0.05);孕检次数≥5次是高龄孕产妇胎盘早剥和胎膜早破的保护因素(P<0.05)。结论高龄能增加妊娠合并症和并发症的风险,临床应加强高龄孕产妇围产期保健管理工作。Objective To investigate the clinical characteristics of pregnant woman in advanced maternal age and the effect of advanced maternal age and pregnancy tests on comorbidity and complications of pregnancy.Methods A total of 111804 pregnant women from six urban areas of Nanning City were selected and divided into low maternal age group(age<35 years old)and advanced maternal age group(age≥35 years old).The clinical characteristics,pregnancy comorbidity or complications of pregnant women were analyzed retrospectively.Results The proportions of cases with early pregnancy examination and number of pregnancy tests≥5 in the advanced maternal age group were significantly lower than those in the low maternal age group,while the proportions of cases with number of pregnancy≥3,history of childbirth,history of cesarean section,artificial or spontaneous abortion≥3 times,reproductive technology assisted pregnancy,multiple pregnancy,exposure to suspicious teratogenic substances during pregnancy and severe high-risk pregnancy were significantly higher than those in the low maternal age group(P<0.05).Multivariate Logistic regression analysis showed that advanced maternal age was the risk factor for gestational hypertension,gestational diabetes,hyperthyroidism or hypothyroidism,anemia,ovarian or uterine tumors,preeclampsia,placental abruption,placenta previa,premature rupture of membranes,abnormal placenta,postpartum hemorrhage and amniotic fluid,while pregnancy tests≥5 times was the protective factor for placental abruption and premature rupture of membranes in pregnant women with advanced maternal age(P<0.05).Conclusion Advanced maternal age can increase the risk of pregnancy comorbidity and complications,so we should strengthen the perinatal health care management services for pregnant women with advanced maternal age.

关 键 词：高龄 孕产妇 孕检 妊娠 子宫肿瘤 胎盘早剥 胎膜早破 前置胎盘 胎位异常 

分 类 号：R715.3[医药卫生—妇产科学] R173[医药卫生—临床医学]