摘要
目的观察不同妊娠间隔时间对高龄单胎妊娠经产妇妊娠结局的影响。方法采用回顾性研究方法分析2020年3月至2023年2月期间在南京鼓楼医院妇产科接受分娩的95例高龄单胎妊娠经产妇临床资料,根据妊娠间隔时间不同,分为<1年组23例、1~2年组25例、3~9年组27例、≥10年组20例。记录4组产妇妊娠期糖尿病、妊娠期高血压、贫血、子痫前期等妊娠期并发症,胎盘残留、宫内窘迫、产后出血等分娩并发症及产程时间、分娩方式、新生儿结局;采用Logistic回归分析分析不同妊娠间隔时间对产妇和新生儿结局的影响。结果≥10年组妊娠期糖尿病、妊娠期高血压、贫血、子痫前期、胎膜早破、胎盘早剥发生率均高于<1年组、1~2年组、3~9年组,且3~9年组妊娠期糖尿病、妊娠期高血压、贫血、子痫前期、胎膜早破、胎盘早剥发生率均高于<1年组、1~2年组,差异均有统计学意义(P<0.05)。≥10年组胎盘残留、胎儿宫内窘迫、羊水污染发生率均高于<1年组、1~2年组、3~9年组,3~9年组胎盘残留、胎儿宫内窘迫、羊水污染发生率均高于<1年组、1~2年组,差异均有统计学意义(P<0.05)。≥10年组剖宫产率、第一产程用时均高于3~9年组、1~2年组、<1年组,3~9年组剖宫产率、第一产程用时均高于1~2年组、<1年组,差异均有统计学意义(P<0.05)。1~2年组的新生儿疾病率、早产率、低出生体重儿率明显低于<1年组、3~9年组、≥10年组,差异均有统计学意义(P<0.05)。<1年组巨大儿率低于1~2年组、3~9年组、≥10年组,差异有统计学意义(P<0.05)。≥10年组新生儿重症监护室转科率明显高于<1年组、1~2年组、3~9年组,差异有统计学意义(P<0.05)。经Logistic回归分析法校正混杂因素后,与1~2年组比较,<1年组早产、妊娠期糖尿病发生风险增高;≥10年组妊娠期糖尿病、子痫前期、胎膜早破发生风险明显增加;妊娠期高血压发生风险在3~9年组、≥10年组明显增加;相对于1~2年组,<1年组、3~9年组、≥10年组的剖宫产发生风险均较高;相对于1~2年组,<1年组、3~9年组、≥10年组的第一产程过长发生风险均较高;相对于1~2年组,<1年组、3~9年组、≥10年组的新生儿疾病发生风险均较高;相对于1~2年组,<1年组、3~9年组、≥10年组的低出生体重儿发生风险均较高。结论不同妊娠间隔时间对高龄单胎妊娠经产妇妊娠结局产生不同影响,相较于其他妊娠间隔时间,妊娠间隔1~2年更有利于获得理想的妊娠结局。
Objective To observe the effect of different gestational intervals on the pregnancy outcomes of elderly singleton pregnancy multiparous women.Methods Retrospective study was used to analyze the clinical data of 95 cases of elderly singleton pregnancy multiparous women who were delivered in the Department of Gynecology and Obstetrics,Nanjing Drum Tower Hospital from March 2020 to February 2023.According to the interval between pregnancies,the multipara were divided into 23 cases in the<1 year group,25 cases in the 1-2 year group,27 cases in the 3-9 year group,and 20 cases in the≥10 year group.The pregnancy complications,such as diabetes,pregnancy hypertension,anemia,pre eclampsia,placental residue Intrauterine distress,postpartum hemorrhage and other delivery complications,as well as the duration of labor,delivery method,and neonatal outcomes,were analyzed using logistic regression to examine the impact of different gestational intervals on maternal and neonatal outcomes.Results The incidences of diabetes,pregnancy induced hypertension,anemia,pre eclampsia,premature rupture of membranes,placental abruption in≥10 year group were higher than those in<1 year group,1-2 year group,3-9 year group,and the incidences of gestational diabetes,gestational hypertension,anemia,pre eclampsia,premature rupture of membranes,placental abruption in the 3-9 year group were higher than those in the<1 year group and 1-2 year group,the differences were statistically significant(P<0.05).The incidences of residual placenta,fetal intrauterine distress,and amniotic fluid contamination in the≥10 year group were higher than those in the<1 year group,the 1-2 year group,and the 3-9 year group,and the incidences of residual placenta,fetal intrauterine distress,and amniotic fluid contamination in the 3-9 year group were higher than those in the<1 year group and 1-2 year group,the differences were statistically significant(P<0.05).The cesarean section rate and first stage labor time in the≥10 year group were higher than those in the 3-9 year group,1-2 year group,and<1 year group,and the cesarean section rate and first stage labor time in the 3-9 year group were higher than those in the 1-2 year group and<1 year group,the differences were statistically significant(P<0.05).The neonatal disease rate,premature birth rate,and low birth weight infant rate in the 1-2 year group were significantly lower than those in the<1 year group,the 3-9 year group,and the≥10 year group,and the incidence of macrosomia in the<1 year group was lower than that in the 1-2 year group,the 3-9 year group,and the≥10 year group,the differences were statistically significant(P<0.05).The transfer rate of neonatal intensive care units in the≥10 year group was significantly higher than those in the<1 year group,1-2 year group,and 3-9 year group,the difference were statistically significant(P<0.05).After adjusting for confounding factors by Logistic regression analysis,the risk of premature delivery and diabetes during pregnancy in the<1 year group was higher than that in the 1-2 year group;≥the risk of diabetes,pre eclampsia and premature rupture of membranes during pregnancy in the≥10 year group increased significantly;the risk of gestational hypertension increased significantly in the 3-9 year group and≥10 year group.Compared to the 1-2 year group,the risk of cesarean section was higher in the<1 year group,the 3-9 year group,and the≥10 year group;compared to the 1-2 year group,the<1 year group,the 3-9 year group,and the≥10 year group had a higher risk of having a long first stage of labor;compared to the 1-2 year group,the risk of neonatal diseases in the<1 year group,the 3-9 year group,and the≥10 year group was higher;compared to the 1-2 year group,the risk of low birth weight infants in the<1 year group,the 3-9 year group,and the≥10 year group was higher.Conclusion Different pregnancy intervals have different effects on the pregnancy outcomes of elderly singleton pregnancy multiparous women.Compared with other pregnancy intervals,pregnancy intervals of 1-2 years are relatively more conducive to obtain ideal pregnancy outcomes.
作者
陶岳
吴旭红
桑丹
汤珏瑶
TAO Yue;WU Xu-hong;SANG Dan(Department of Gynaecology and Obstetrics,Nanjing Drum Tower Hospital,Nanjing Jiangsu 210008,China)
出处
《临床和实验医学杂志》
2024年第2期200-203,共4页
Journal of Clinical and Experimental Medicine
基金
江苏省妇幼健康科研项目(编号:F2018260)。
关键词
妊娠结局
妊娠并发症
高龄
单胎妊娠
经产妇
妊娠间隔时间
Pregnancy outcomes
Pregnancy complications
Elderly
Singleton pregnancy
Multipara
Pregnancy interval
