摘要
目的:探讨二孩剖宫产产后出血的影响因素及与宫内节育器(IUD)的相关性。方法:采用病例对照研究方法收集连云港地区孕产保健系统2017年1月-2018年12月剖宫产分娩且符合纳入标准的二胎产妇4994例,其中产后出血量≥1000 ml 120例为病例组,按1:2完全随机抽取产后出血量<1000 ml的240例产妇为对照组,logistic回归分析产后出血的影响因素。结果:年龄(OR=7.228,95%CI 3.420~15.274)、流产史(OR=2.121,95%CI 1.198~3.755)、多胎妊娠(OR=1.923,95%CI 1.067~3.465)、巨大儿(OR=6.558,95%CI 3.608~11.92)、前置胎盘(OR=4.300,95%CI 1.572~11.757)是产后出血的独立影响因素,使用IUD不是产后出血的独立影响因素(OR=7.608,95%CI 0.778~74.396)。结论:放置IUD对剖宫产产后出血没有影响,值得拟生育二胎妇女使用。控制产后出血的危险因素可以预防剖宫产产后出血的发生。
Objective:To analyze the relationship between intrauterine device(IUD)used of women and their risk factors of postpartum hemorrhage after the second child birth by cesarean section.Methods:A case-control study was conducted to analyze the postpartum hemorrhage situation of 4,994 parturients with the second child birth by cesarean section from January 2017 to December 2018 and who met the inclusion criteria in the maternal health care system of Lianyungang area.Among them,120 parturients with postpartum blood loss≥1,000 ml were classified in case group,and according to 1:2,240 parturients with postpartum hemorrhage<1,000 ml were randomly selected in control group.The influence factors of postpartum hemorrhage were analyzed by logistic regression analysis.Results:Age(OR=7.228,95%CI 3.420-15.274),history of abortion(OR=2.121,95%CI 1.198-3.755),multiple pregnancy(OR=1.923,95%CI 1.067-3.465),macrosomia(OR=6.558,95%CI 3.608-11.92),and placenta previa(OR=4.300,95%CI 1.572-11.757)were the independent influencing factors of postpartum hemorrhage,but IUD used was not the independent influencing factor of postpartum hemorrhage(OR=7.608,95%CI 0.778-74.396).Conclusion:IUD used has no adverse influence on the postpartum hemorrhage of the women after cesarean section,so IUD is worth to use as the contraception for the women safely who plan to give birth the second child.Controlling the risk factors of the women can prevent their occurrence of postpartum hemorrhage after cesarean section.
作者
龙驭云
沈立平
杨月华
李宝霞
张敏
仝娇
左慧
孙志明
LONG Yuyun;SHEN Liping;YANG Yuehua;LI Baoxia;ZHANG Min;TONG Jiao;ZUO Hui;SUN Zhiming(Maternal and Child Health Hospital of Lianyungang City,Jiangsu Province,222000;Jiangsu Province Health Development Research Center,National Health and Family Planning Commission Contraceptives Adverse Reaction Surveillance Center,Nanjing)
出处
《中国计划生育学杂志》
2023年第1期112-116,共5页
Chinese Journal of Family Planning
基金
国家人口计生委计划生育药具不良反应监测中心重点实验室开放基金项目(YJJC201801)。
关键词
产后出血
剖宫产
宫内节育器
危险因素
Postpartum Hemorrhage
Cesarean Section
Intrauterine device
Risk Factor
