摘要
目的:了解浏阳市产后出血的发病情况,并探讨其相关的危险因素.方法:采用整群随机抽样的方法在浏阳市37个乡镇(街道)中随机选取14个乡镇(街道),以所选取乡镇(街道)的妇幼保健部门在2010年1月至2011年12月间登记建册的所有孕产妇为研究对象,对研究对象孕早、孕中、孕晚及分娩各期进行随访,收集其孕产妇保健手册和病历资料.以手册和病历记录的产后出血量超过500 mL为病例,从该队列无产后出血(出血量＜500 mL)的人群中采用完全随机抽样的方法抽取相同数目的产妇为对照.分别采用卡方检验和非条件logistic回归分析进行单因素和多因素分析,以探讨产后出血发生的主要影响因素.结果:共收集到5 933名产妇的资料,其中有132例诊断为产后出血,产后出血发生率为2.22％.多因素非条件logistic回归分析结果显示:影响产后出血发生的主要危险因素有贫血(OR=3.940,95％ CI:2.100～7.389),疤痕子宫(OR=2.730,95％CI:1.198～6.220),胎盘前置(OR=10.665,95％ CI:1.142～99.566),胎盘因素(OR=4.332,95％CI:1.004～18.692),产程延长(OR=5.899,95％ CI:2.602～13.376).结论:产后出血是多种因素综合作用的结果,应针对主要危险因素尽早采取综合性控制措施以减少产后出血的发生.
Objective: To investigate the incidence and risk factors of postpartum hemorrhage in Liuyang City, Hunan Province. Methods: h is was a nested case-control study. A total of 14 townships were randomly selected by cluster random sampling method from 37 townships in Liuyang City, Hunan Province. All women who got pregnant and childbirth from January 2010 to December 2011 in the above 14 townships were selected and followed up at i rst-trimester, second trimester, third trimester and each deliveryperiod. Data were collected directly from maternal care manuals and the clinical records from the subjects' delivery hospitals. h ese whose postpartum bleeding was more than 500 mL were selected as cases, and the same amounts of normal maternal in the same cohort study whose postpartum bleeding was less than 500 mL were selected as controls. χ2 test and unconditional logistic regression analysis were applied to identify the determinants. Results: A total of 5 933 women were included in our study. The incidence of postpartum hemorrhage was 2.22%. Unconditional logistic regression analysis showed that the risk factors for postpartum hemorrhage mainly included anemia(OR=3.940, 95% CI: 2.100-7.389), scarred uterus(OR=2.730, 95% CI: 1.198-6.220), placenta previa(OR=10.665, 95% CI: 1.142-99.566), placental factors(OR=4.332, 95% CI: 1.004-18.692), and prolonged pregnancy(OR=5.899, 95% CI: 2.602-13.376). Conclusion: Postpartum hemorrhage is caused by complicated factors. Comprehensive measures should be taken to reduce postpartum hemorrhage.
出处
《中南大学学报（医学版）》
CAS
CSCD
北大核心
2014年第2期151-156,共6页
Journal of Central South University ：Medical Science
基金
国家自然科学基金(30872167)~~
关键词
产后出血
影响因素
巢式病例对照研究
postpartum hemorrhage
risk factor
nested case-control study
