新生育政策下不同高龄段孕产妇安全性分析  

Analysis on the safety of different aged pregnant women under the new birth policy

作　　者：张悦[1] 陈红波[2] 刘羽[1] ZHANG Yue;CHEN Hongbo;LIU Yu(Gynecology Department,Maternal and Child Health Hospital of Anhui Medical University,Hefei,Anhui 230031,China;不详)

机构地区：[1]安徽医科大学附属妇幼保健院妇二科,安徽合肥230031 [2]安徽医科大学附属妇幼保健院产一科

出　　处：《中华全科医学》2023年第4期629-631,636,共4页Chinese Journal of General Practice

基　　金：安徽省自然科学基金面上项目(2108085MH260)。

摘　　要：目的 在我国生育政策发生改变及规范化管理高龄孕产妇背景下,探讨我院规范管理下高龄段孕产妇妊娠安全问题。方法 选取2020年1—12月461例于安徽省妇幼保健医院分娩的单胎孕产妇。根据孕产妇年龄分为适龄组(20~34岁)184例,高龄组(35~39岁)147例,超高龄组(≥40岁)130例,分析高龄组与超高龄组孕产妇妊娠期并发症与妊娠结局。结果 适龄组妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产、流产、胎儿窘迫发生例数分别为38例、76例、3例、53例、13例、26例,高龄组妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产、流产、胎儿窘迫发生例数分别为54例、44例、10例、84例、9例、9例,超高龄组妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产、流产、胎儿窘迫发生例数分别为51例、4例、3例、46例、27例、11例。单因素分析显示,3组孕产妇妊娠期糖尿病、胎膜早破、前置胎盘、剖宫产、流产、胎儿窘迫比较差异有统计学意义,调整一般情况后,高龄组孕产妇剖宫产风险高于适龄组,超高龄组孕产妇流产风险高于适龄组。结论 本研究发现高龄产妇剖宫产风险高于适龄产妇,超高龄孕产妇流产风险高于适龄孕产妇,其余妊娠期并发症及妊娠结局与年龄未呈相关性。规范管理可有效地保障高龄孕产妇的安全性。Objective To discusses the pregnancy safety of different elderly pregnant women under the background of the change in birth policy and the standardized management of elderly pregnant women.Methods The clinical data of 461 singleton pregnant women in the Anhui Provincial Maternal and Child Health Hospital from January 2020 to December 2020 were collected.According to the maternal age,they were divided into age-appropriate maternity group(20-34 years old,184 cases),the advanced maternal age group(35-39 years old,147 cases)and very advanced maternal age group(more than 40 years,130 cases).Pregnancy complications and outcomes were analyzed.Results The gestational diabetes mellitus,premature rupture of membranes,placenta praevia,caesarean section,miscarry,fetal distress were 38,76,3,53,13,26 cases respectively in the age-appropriate maternity group,above those in the advanced maternal age group were 54,44,10,84,9,9 cases respectively,and those in the very advanced maternal age group were 51,4,3,46,27,11 cases respectively.Univariate analysis showed that gestational diabetes mellitus,premature rupture of membranes,placenta previa,cesarean section,abortion and fetal distress were statistically significant.After adjusting the general situation,the risk of cesarean section in the advanced maternal age group is higher than that in the age-appropriate maternity group,and the risk of abortion in the very advanced maternal age group is higher than that in the age-appropriate maternity group.Conclusion The risk of caesarean section in the advanced maternal age women was higher than that in pregnant women of appropriate age.The risk of abortion in the advanced maternal age women was higher than that in pregnant women of appropriate age.There is no age-related correlation between other complications and pregnancy outcomes.Standardized management effectively protects the safety of elderly pregnant women.

关 键 词：超高龄产妇 流产 剖宫产 

分 类 号：R714.61[医药卫生—妇产科学] R714.25[医药卫生—临床医学]