摘要
目的探讨高龄对双胎妊娠结局的影响。方法回顾性分析1819例双胎妊娠产妇及其新生儿的临床资料,根据产妇年龄分为高龄组(年龄≥35岁,292例)和适龄组(年龄<35岁,1527例)。比较两组产妇一般情况、妊娠期合并症以及新生儿一般情况、严重并发症发生情况及结局。采用logistic回归分析双胎新生儿发生不良结局的独立危险因素。结果 (1)高龄组产妇不良孕产史、经产妇、瘢痕子宫比例及体外授精-胚胎移植使用率高于适龄组(P<0.05)。高龄组产妇妊娠期合并症如糖尿病、高血压病、肝内胆汁淤积症、前置胎盘、子宫肌瘤及血小板减少的发生率高于适龄组(P<0.05)。高龄未增加早产、死胎及胎儿畸形的风险。(2)高龄组新生儿大胎龄早产儿占比、出生体重、剖宫产率高于适龄组(P<0.05)。高龄未增加低Apgar评分、小于胎龄儿及新生儿重症监护病房住院的风险。(3)高龄组新生儿呼吸窘迫综合征发生率、呼吸支持及肺表面活性物质使用率低于适龄组(P<0.05),但两组新生儿死亡率及严重并发症发病率无统计学差异(P>0.05)。(4)Logistic回归分析显示,胎龄小是双胎新生儿发生呼吸窘迫综合征的独立危险因素(P<0.05),产妇是否高龄与之无关(P>0.05)。结论高龄未增加双胎妊娠新生儿不良结局及死亡率,但高龄产妇妊娠期合并症发生率高。
Objective To investigate the effect of advanced age on the outcomes of twin pregnancy.Methods The clinical data of 1819 twin pregnant women and their newborns were retrospectively reviewed.According to age, the women were divided into two groups of A(≥35 years old, 292 cases) and B(<35 years old, 1527 cases).The general situation, pregnancy complications of the pregnant women and general situation, occurrence and outcome of serious complications of the newborns were compared between the two groups.Logistic regression was used to analyze the independent risk factors for the adverse outcomes of the twins.Results The proportions of adverse pregnancy history, prenatal pregnancy, scar uterus and the incidence of in vitro fertilization-embryo transfer in group A were higher than those in group B(P<0.05).The incidence rates of pregnancy-related complications such as diabetes mellitus, hypertension, intra-hepatic cholestasis, placenta previa, uterine fibroids and thrombocytopenia in group A were higher than those in group B(P<0.05).Older maternal age did not increase the risk for premature birth, stillbirth or fetal deformities.The proportions of premature infant with older gestational age, Cesarean section rate and neonatal birth weight in group A were higher than those in group B(P<0.05).Older maternal age did not increase the risk for low Apgar score, small for gestational age or neonatal intensive care unit hospitalization.The incidence rates of neonatal respiratory distress syndrome, respiratory support and use of pulmonary surfactant substances in group A were lower than those in group B(P<0.05).There were no significant differences in neonatal mortality and serious complications between the two groups(P>0.05).Logistic regression analysis showed that younger gestational age was an independent risk factor for the development of respiratory distress syndrome of the twins(P<0.05),which was not associated with older maternal age(P>0.05).Conclusion Advanced maternal age does not increase the adverse outcomes and neonatal mortality of twin pregnancy, but the incidence of complications in the pregnancy of older maternal age is increased.
作者
朱金改
李亚琴
陈小慧
余章斌
ZHU Jingai;LI Yaqin;CHEN Xiaohui(Department of Pediatrics,Affiliated Maternity Hospital(Nanjing Maternity and Child Health Care Hospital),Nanjing Medical University,Nanjing 210004,CHINA)
出处
《江苏医药》
CAS
2021年第9期894-898,共5页
Jiangsu Medical Journal
基金
江苏省医学青年人才(QNRC2016114)
江苏“六个一工程”拔尖人才资助项目(LGY2019008)。
关键词
高龄
双胎妊娠
新生儿
妊娠合并症
Advanced age
Twin pregnancy
Newborn
Pregnancy complications
