摘要
目的探讨子痫前期(preeclampsia, PE)并发胎儿生长受限(fetal growth restriction, FGR)的相关危险因素和妊娠结局。方法回顾性分析2018年7月至2020年12月广州医科大学附属第六医院237例PE孕妇临床资料,根据是否发生FGR分为PE并发FGR组(观察组)以及未并发FGR组(对照组),比较两组一般情况、临床数据、母体并发症及新生儿资料。结果 (1)乳酸脱氢酶(lactate dehydrogenase, LDH)(P=0.004,OR=1.005)及中性粒细胞/淋巴细胞比值(中淋比)偏高(P=0.041,OR=1.180)是PE并发FGR的独立危险因素,孕期增重≥15 kg为其保护因素(P=0.006,OR=0.320),联合诊断其ROC曲线下面积大于单一诊断;(2)母婴结局方面,在低蛋白血症、肝肾功能损害、胸腹水、HELLP综合征、重度窒息、胎儿或新生儿死亡、代谢性酸中毒、呼吸窘迫综合征及新生儿住院天数超过20天等方面比较,观察组发生率高于对照组,差异有统计学意义(P<0.05);(3)分娩孕周及新生儿体质量方面,观察组均低于对照组,差异有统计学意义(P<0.05)。结论 LDH及中淋比偏高是PE并发FGR的独立危险因素,孕期增重≥15 kg为其保护因素,PE并发FGR孕妇普遍分娩孕周小、新生儿体质量低以及易发生母婴不良妊娠结局。
Objective To investigate the risk factors and pregnancy outcome of preeclampsia(PE) complicated with fetal growth restriction(FGR).Methods The clinical data of 237 pregnant women with PE in the Sixth Hospital Affiliated to Guangzhou Medical University,from July 2018 to September 2020 were retrospectively collected and analyzed.According to whether FGR occurred, they were divided into two groups: PE complicated with FGR group(observation group) and not complicated with FGR group(control group).The general situation, clinical data, maternal complications and neonatal data of the two groups were compared.Results(1) Elevated lactate dehydrogenase(LDH)(P=0.004,OR=1.005) and neutrophils lymphocyte ratio(NLR)(P=0.041,OR=1.180) were independent risk factors for PE complicated with FGR,and weight gain ≥15 kg during pregnancy was protective factor(P=0.006,OR=0.320),the area under ROC curve of combined diagnosis was larger than that of single diagnosis;(2) In terms of maternal and infant outcomes, the ratio of hypoproteinemia, liver and kidney function damage, pleural and ascites, HELLP syndrome, severe asphyxia, fetal or neonatal death, metabolic acidosis, respiratory distress syndrome and neonatal hospital stay more than 20 days compared with the control group, the incidence rate of the observation group were higher, the differences were statistically significant(P<0.05);(3) The gestational weeks of delivery and neonatal body weight of the observation group were lower than those of the control group, the difference was statistically significant(P<0.05).Conclusion Elevated LDH and NLR are independent risk factors for PE complicated with FGR,and weight gain during pregnancy ≥15 kg is a protective factor.Pregnant women with PE complicated with FGR generally have small gestational weeks, low birth weight and prone to adverse pregnancy outcomes.
作者
彭翠
贺惠琴
佘芹
成志
曾木兰
温穗文
Peng Cui;He Huiqin;She Qin;Cheng Zhi;Zeng Mulan;Wen Suiwen(Department of Obstetries,The Sixth Hospital Afiliated to Guangzhou Medical Universit,fingyuan Guangdong 511518,P.R.China)
出处
《中国计划生育和妇产科》
2022年第1期70-75,共6页
Chinese Journal of Family Planning & Gynecotokology
基金
清远市科技计划项目(项目编号:190912094569080)。
