淮安市高危妊娠因素的流行特征及其对妊娠结局的影响  

Epidemiological characteristics of high-risk pregnancy and its association with pregnant outcomes in Huai'an

作　　者：丁伟洁 张悦 王慧 王丹洋 孙春霞 李晓宇 戚婷婷 岳虹霓 朱晓琴 徐小林 DING Wei-jie;ZHANG Yue;WANG Hui;WANG Dan-yang;SUN Chun-xia;LI Xiao-yu;QI Ting-ting;YUE Hong-ni;ZHU Xiao-qin;XU Xiao-lin(Affiliated Hospital of Yangzhou University Huai'an Maternal and Child Health Care Center,Huai'an,Jiangsu 223002,China)

机构地区：[1]扬州大学附属淮安市妇幼保健院,江苏淮安223002 [2]浙江大学公共卫生学院 [3]浙江大学医学院附属第二医院临床大数据与统计中心

出　　处：《中国妇幼保健》2023年第12期2218-2223,共6页Maternal and Child Health Care of China

基　　金：江苏省妇幼健康科研项目(F201932);江苏省卫生健康委医学科研重点项目(ZD2021044);江苏省医院管理创新研究课题(JSYGY-3-2020-442);江苏省淮安市科技项目(HAB202043);中华医学基金会公开竞争项目(21-416)。

摘　　要：目的分析淮安市高危妊娠因素的流行病学特征及其对妊娠结局的影响。方法以淮安市2015年所有住院分娩产妇为研究对象,通过问卷调查收集其产前基本人口学资料、高危妊娠因素及妊娠结局等信息,计数资料采用频数和百分比描述,计量资料采用(x±s)表示,组间比较采用χ^(2)检验或t检验,建立logistic回归模型分析高危妊娠因素与妊娠结局的关系。结果共59190例产妇纳入分析,高危妊娠发生率为74.1%,常见的前3位高危因素分别为:24 kg/m^(2)<孕前BMI<28 kg/m^(2)(17.5%)、瘢痕子宫(17.1%)及胎动减少/频繁(11.3%)。发生1种高危因素的产妇占36.0%,有2种的占23.8%,有3种及以上的占14.3%。与非高危妊娠组相比,高危妊娠更常见于低学历、农村户口、家庭年收入<1万的人群。logistic回归分析结果显示,随着高危妊娠因素数量的增多,围生儿发生死亡、早产、剖宫产及出生窒息等不良妊娠结局的比值比增高。结论淮安市孕产妇合并多种高危妊娠因素比例较高,干预的重点人群是低学历、低收入及农村户籍人群。加强基层孕产保健服务的可及性,完善高危孕产妇分级管理体系,对重点高危因素进行干预,做好高危妊娠专案管理,是提高地区母婴健康水平的关键。Objective To explore and analyze the epidemiological characteristics of factors associated with high-risk pregnancy'and their effects on pregnancy outcomes.Methods Data of all inpatient pregnant women who gave birth in 2015 in Huai'an City,Jiangsu Prov-ince were collected by self-administered questionnaire,including basic characteristics,factors associated with high-risk pregnancy and pregnancy outcomes.Descriptive statistics were employed to present basic characteristics by two groups of high-risk and non-high-risk preg-nancy.Continuous variables were presented with mean±standard deviation and categorical results were expressed as frequencies(percenta-ges).Chi-square tests or t tests were used for comparison between groups.Logistic regression was used to examine the association between the factors associated with high-risk pregnancy and pregnancy outcomes.ResultsA total of 59190 pregnant women were included,74.1%of whom were high-risk pregnancies.The top three factors associated with high-risk pregnancy were 24<pre-pregnancy body mass index<28(17.5%),scarred uterus(17.1%),and frequently decreased fetal movement(11.3%).Besides,the percentages of pregnant women with 1,2 or 3 risk factors were 36.0%,23.8%and 14.3%respectively.Moreover,women who were high-risk pregnant were more likely to be less educated,have less income and live in rural area.The increased number of risk factors were associated with higher odds of incidence of perinatal death,premature delivery,cesarean delivery,and neonatal asphyxia.Conclusion Pregnant women with low educa-tion levels,low income or living in rural area should be considered as priority group in the management of high-risk pregnancy.Ensuring the accessibility of maternal health services in primary care settings is crucial for improving maternal and infant health in Huai'an City.

关 键 词：孕产妇 高危妊娠 妊娠结局 瘢痕子宫 

分 类 号：R473.71[医药卫生—护理学]