摘要
目的：探讨稽留流产发生的高危因素。方法：通过病例-对照回顾性研究，收集稽留流产病例1945例，同时与1874例因非意愿妊娠20周内的单活胎要求终止妊娠者（包括妊娠〈12周自愿要求终止妊娠者以及妊娠12～20周内因内外科因素不宜妊娠者1的病例资料进行对比。分析与稽留流产发病相关的高危因素及环境等因素在稽留流产中可能产生的影响。结果：①Logistic多因素回归分析显示，与1945例稽留流产发病正相关的危险因素包括：室外职业者（DR=1．777，95％CI=1．538N2．052），初产妇（OR=2．305，95％CI=2．0l3～2．638），自然流产史（DR=2．359，95％CI=1．703-3．268），贫血（DR=5．498，95％CI=2．243-13．473），乙肝病毒携带者（OR=8．126，95％CI=4．688～14．084）：与稽留流产发病负相关的危险因素为人工流产≥3次（OR=0．726，95％CI=0．573～0．920）。②稽留流产独立因素构成变化显示，环境因素及一些未知因素等构成比升高（P〈0．05），与稽留流产发病数增加有关。结论：室外职业者、初产妇、自然流产病史、贫血和乙肝病毒携带者是稽留流产发生的独立危险因素，其中环境因素及一些未知因素的构成比随稽留流产发病数增加而升高。初步推论：基因、生育史、合并症不能解释稽留流产发病数的升高，而环境因素和一些未知因素可能是稽留流产病例数升高的重要原因之一。
Objective： To determine the risk factors related to missed abortion. Methods： This was a case-control study. We collected data for 1 945 cases of missed abortion in contrast to 1 874 cases of normal pregnancy within 20 weeks of gestation, including those who are pregnant for less than 12 weeks and request voluntarily to terminate and those for from 12 to 20 weeks but inappropriate to be pregnant because of internal or surgical diseases. χ^2 test and Logistic regressive model were used to evaluate the association of independent risk factors and the uncertain factors, such as environment, with missed abortion so as to explore the reasons for increasing number of patients suffered from missed abortion. Results： 1） Logistic regression model indicated that there were 5 independent risk factors were positively correlated with missed abortion, including outdoor working environment （OR=1.777, 95%CI=1.538-2.052）, primipara （OR--2.305, 95%CI=2.013- 2.638）, spontaneous abortion history （OR=2.359, 95%CI=1.703-3.268）, anemia （OR=5.498, 95%CI=2.243- 13.473） and hepatitis B virus carrier （OR=8.126, 95%CI=4.688- 14.084）. Only one risk factor was negatively correlated with missed abortion, which was induced abortion history of 3 times or greater （OR=0.726, 95%CI= 0.573-0.920）. 2） Further research on the changes of components for independent factors of missed abortion showed that, environmental factors and unknown factors were correlated to the increased number of missed abortion （P〈0.05）. Conclusion： Outdoor profession, primipara, spontaneous abortion, anemia and hepatitis B virus carrier were independent risk factors of missed abortion. Among all these risk factors, increased con-stituent of outdoor profession and unknown factors were found to have contribution to the increase of missed abortion. In summary, we primary concluded that genes, reproductive history and complications of pregnancy would not explain the elevated cases of missed abortion, while environmental factors and the other unknown reasons might be the main reasons.
出处
《生殖与避孕》
CAS
CSCD
北大核心
2016年第3期195-201,共7页
Reproduction and Contraception
关键词
稽留流产
高危因素
病例对照研究
missed abortion
high risk factors
case-control study
