摘要
目的探讨三孩高龄产妇的妊娠特征、分娩方式以及围生儿结局,为三孩高龄产妇提供更好的围生期保健服务。方法回顾性收集2019年3月至2023年5月期间分娩的三孩高龄产妇44例及以同期适龄三孩产妇116例临床资料,对两组产妇基本情况、妊娠合并症、产科并发症、分娩方式及围生儿结局进行比较分析。结果与对照组比较,研究组孕妇平均年龄大,孕次及流产次数多,第1次、2次分娩间隔时间长,孕期体质量增长过多,差异均有统计学意义(P<0.05);研究组产妇在妊娠高血压疾病、妊娠糖尿病、胎盘植入、妊娠期肝内胆汁淤积症、胎膜早破、妊娠合并乙型病毒肝炎及早产方面的发生率明显高于对照组,差异均有统计学意义(P<0.05);研究组3次均阴道分娩的比例小于对照组,而有2次阴道分娩史的剖宫产率及生育第三孩的剖宫产率则大于对照组(P<0.05);研究组巨大儿、低出生体质量儿、新生儿低血糖的发生率高于对照组,差异均有统计学意义(P<0.05)。结论三孩高龄产妇的临床情况复杂,妊娠合并症、产科并发症及围生儿不良结局增多,剖宫率高。应加强三孩高龄产妇的围生期保健管理,减少不良妊娠结局,降低剖宫产率。
Objective To investigate the pregnancy characteristics,delivery mode,and perinatal outcomes of advanced age puerpera of three-child,to provide better perinatal healthcare services for three-child pregnancy women.Methods We retrospectively collected the clinical data of 44 advanced age puerpera of three-child who gave birth from March 2019 to May 2023,and 116 age-appropriate puerpera of three-child during the same period.We compared the basic conditions of puerpera,pregnancy complications,obstetric complications,mode of delivery,and perinatal outcomes.Results Compared with the control group,the study group had more advanced age,pregnancy times and abortions,longer intervals between the first and second child,and over-weight gain during pregnancy,the differences were statistically significant(P<0.05).The incidence of pregnancy-induced hypertension syndrome,gestational diabetes mellitus,placenta accreta,intrahepatic cholestasis of pregnancy,premature rupture of membrane,pregnancy-associated hepatitis B virus infected and preterm delivery in the study group were significantly higher than those in the control group(P<0.05).The ratio of three times vaginal deliveries in the study group was less than the control group,but the rate of cesarean section of puerpera who have two vaginal delivery histories and the rate of cesarean section for the third-child were all higher than the control group(P<0.05).The incidence of macrosomia,low birth weight infants,and neonatal hypoglycemia in the study group were higher than the control group,and the differences were statistically significant(P<0.05).Conclusion Advanced age puerpera of three-child have more complex clinical conditions,including increased complications during pregnancy and obstetric complications,and more poor perinatal outcomes,and a higher rate of cesarean section.It is necessary to strengthen the perinatal care management of advanced age puerpera of three-child,in order to reduce the adverse pregnancy outcomes and the rate of cesarean section.
作者
程贤鹦
程丽
王园园
张朋辉
徐丽雅
CHENG Xianying;CHENG Li;WANG Yuanyuan;ZHANG Penghui;XU Liya(Department of Obstetrics and Gynecology,Shulan(Hangzhou)Hospital,Hangzhou,Zhejiang 310022,China;Department of Obstetrics and Gynecology,Hangzhou Xixi Hospital,Hangzhou,Zhejiang 310023,China;Zhejiang Chinese Medical University,Hangzhou,Zhejiang 310053,China)
出处
《中国优生与遗传杂志》
2024年第1期196-199,共4页
Chinese Journal of Birth Health & Heredity
基金
杭州市拱墅区医药卫生科技计划项目(202208)
杭州市卫生科技计划项目(20220020)
浙江省中医药科技计划项目(2023ZL591)。
关键词
三孩产妇
高龄产妇
妊娠特征
分娩方式
围生儿结局
puerpera of three-child
advanced age puerpera
pregnancy characteristics
delivery mode
perinatal outcome
