4400例妊娠妇女孕中晚期引产原因分析  

Analysis of the causes of labor induction in the second and third trimesters of 4400 pregnant women

作　　者：钟银莉 吴新华 罗灿[1] 王雄虎[1] 朱颖贤 ZHONG Yinli;WU Xinhua;LUO Can;WANG Xionghu;ZHU Yingxian(Guangdong Women and Children Hospital,Guangdong Guangzhou 511422,China)

机构地区：[1]广东省妇幼保健院,广东广州511442

出　　处：《中国妇幼健康研究》2022年第7期72-78,共7页Chinese Journal of Woman and Child Health Research

基　　金：广东省医学科学技术研究基金项目(NO:201942592018230)。

摘　　要：目的 了解2015-2019年4 400例妊娠妇女孕中晚期引产的原因及其在不同年份与孕周的变化趋势,提出降低孕中晚期引产率的措施,以保障母婴安全。方法 回顾性分析2015-2019某三甲妇幼保健院的4 400例中晚期妊娠妇女的引产资料,对不同年份与孕周的妊娠妇女孕中晚期引产原因变化趋势采用趋势性χ^(2)检验分析。结果 导致孕中晚期引产的原因中,胎儿因素占比最大(52.84%),其次为流产(31.68%)和其他因素(14.23%),母体因素占比最小(1.25%)。胎儿因素以胎儿畸形为主(36.27%),其中85.28%为非致死性胎儿畸形,非致死性胎儿畸形中染色体异常(16.42%)、多系统畸形(15.35%)和非致死性先天性心脏病(10.71%)居前三位;致死性胎儿畸形占胎儿畸形的14.72%,其中先天性心脏病(5.01%)、重型地中海贫血(3.57%)、单腔心(1.57%)居前三位。随着年份和孕周的增长,胎儿因素所占同期引产数的比例增加,流产和其他因素的比例有下降趋势,母体因素的比例平稳,4个因素的趋势性检验均有统计学意义(不同年份χ_(趋势)^(2)=25.780,P<0.001;不同孕周χ_(趋势)^(2)=757.960,P<0.001)。结论 胎儿因素是妊娠妇女孕中晚期引产的主要原因,提示孕产妇应尽早规范产检,及时发现胎儿畸形,对于因非致死性胎儿畸形引产的孕妇,应做好宣教,提高其对出生缺陷的认知,避免不必要的引产。Objective To understand the causes for the induction of labor in the second and third trimester of pregnancy of 4400 pregnant women from 2015 to 2019,and their changing trends in different years and gestational weeks.To propose measures to reduce the rate of labor induction in the second and third trimesters to ensure the safety of mothers and babies.Methods The data of 4400 pregnant women who received labor induction in the second and third trimesters from 2015 to 2019 in a tertiary-grade maternal and child health care hospital were retrospectively analyzed.Descriptive statistics and Chi square trend test were used to analyze the causes of labor induction and the changing trends in different years and gestational weeks.Results Among the causes of labor induction in the second and third trimesters,fetal factors accounted for the largest proportion(52.84%),followed by miscarriage(31.68%)and other factors(14.23%),and maternal factors accounted for the smallest proportion(1.25%).Fetal malformations were the main factors(36.27%),of which 85.28%were non-fatal fetal malformations.The chromosomal abnormalities(16.42%),multisystem malformations(15.35%)and non-fatal congenital heart disease(10.71%)ranked the top three among the non-fatal fetal malformations.Fatal fetal malformations accounted for 14.72%of fetal malformations,among which congenital heart disease(5.01%),severe thalassemia(3.57%),and single-chamber heart(1.57%)ranked the top three.With the increase of years and gestational weeks,the proportion of fetal factors in the number of labor induction in the same period increased,the proportion of miscarriage and other factors decreased,and the proportion of maternal factors remained stable.According to the Chi square trend test,the differences in the causes for labor induction in different years and gestational weeks were statistically significant(different years:χ_(trend)^(2)=25.780,P<0.001;different gestational weeks:_(trend)^(2)=757.960,P<0.001).Conclusions Fetal factors are the main reason for the induction of

关 键 词：孕中晚期 引产 胎儿因素 母体因素 出生缺陷 

分 类 号：R173[医药卫生—妇幼卫生保健]