胎膜早破合并绒毛膜羊膜炎患者不良妊娠结局影响因素分析  

Analysis of Influencing Factors of Adverse Pregnancy Outcomes in Patients with Premature Rupture of Membranes and Chorioamnionitis

作　　者：刘丽娟 陈奕 刘婷 LIU Lijuan;CHEN Yi;LIU Ting(Second Department of Obstetrics,Ruijin Maternal and Child Health Hospital,Ruijin 342500,China;不详)

机构地区：[1]瑞金市妇幼保健院产二科,江西瑞金342500 [2]瑞金市妇幼保健院妇产科,江西瑞金342500

出　　处：《中国医学创新》2024年第19期173-177,共5页Medical Innovation of China

摘　　要：目的:分析胎膜早破(PROM)合并绒毛膜羊膜炎(CAM)患者不良妊娠结局的影响因素。方法:选择2019年1月—2023年1月于瑞金市妇幼保健院分娩的124例经胎盘病理确诊CAM的PROM患者临床资料进行回顾性分析,依据妊娠结局分为不良妊娠结局组(85例)与正常妊娠结局组(39例)。对比两组患者特征,采用多因素logistic回归分析筛选不良妊娠结局的独立危险因素。结果:不良妊娠结局组多胎妊娠、妊娠晚期同房、合并生殖道感染、胎位异常患者占比均大于正常妊娠结局组,差异均有统计学意义(P<0.05),PROM孕周、分娩前羊水指数(AFI)均小于正常妊娠结局组,差异均有统计学意义(P<0.05),确诊PROM至分娩时间长于正常妊娠结局组,差异有统计学意义(P<0.05),C反应蛋白(CRP)、白细胞(WBC)计数水平均大于正常妊娠结局组,而血清肿瘤坏死因子相关蛋白-3(CTRP3)水平低于正常妊娠结局组,差异均有统计学意义(P<0.05);分娩前AFI大、CTRP3水平高为不良妊娠结局发生的保护因素(P<0.05);合并生殖道感染、确诊PROM至分娩时间长、WBC水平高是不良妊娠结局发生的独立危险因素(P<0.05)。结论:分娩前AFI、合并生殖道感染、确诊PROM至分娩时间、WBC及CTRP3水平为PROM合并CAM患者不良妊娠结局的影响因素。Objective:To analyze the influencing factors of adverse pregnancy outcomes in patients with premature rupture of membranes(PROM)and chorioamnionitis(CAM).Method:A retrospective analysis was conducted on the clinical data of 124 PROM patients with CAM confirmed by placental pathology who gave birth at Ruijin Maternal and Child Health Hospital from January 2019 to January 2023.According to pregnancy outcomes,they were divided into an adverse pregnancy outcome group(85 cases)and a normal pregnancy outcome group(39 cases).The characteristics of two groups of patients were compared and multivariate logistic regression analysis was used to screen for independent risk factors for adverse pregnancy outcomes.Result:The proportions of patients with multiple pregnancies,late pregnancy sexual intercourse,combined reproductive tract infections,and abnormal fetal position in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group,the differences were statistically significant(P<0.05).The gestational weeks and amniotic fluid index(AFI)before delivery of PROM in the adverse pregnancy outcome group were lower than those in the normal pregnancy outcome group,the differences were statistically significant(P<0.05).The time from diagnosis of PROM to delivery in the adverse pregnancy outcome group was longer than that in the normal pregnancy outcome group,the difference was statistically significant(P<0.05).The levels of C reactive protein(CRP)and white blood cell count(WBC)in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group,while the levels of CTRP3 in the adverse pregnancy outcome group was lower than that in the normal pregnancy outcome group,the differences were statistically significant(P<0.05).High levels of AFI and CTRP3 before delivery were protective factors for adverse pregnancy outcomes(P<0.05);the combination of reproductive tract infections,long time from diagnosis of PROM to delivery,and high WBC levels were independent risk factors

关 键 词：胎膜早破 绒毛膜羊膜炎 不良妊娠结局 羊水指数 影响因素 

分 类 号：R714.433[医药卫生—妇产科学]