摘要
目的：分析近十年华中科技大学同济医学院附属同济医院早产相关情况的变迁，旨在为制定早产防治策略提供依据。方法：选择2000年1月至2009年12月分娩的2880例早产产妇（早产组）和系统抽样的方法随机抽样的2880例足月产产妇（对照组）的临床资料进行病例对照研究，并将早产组分为2000～2004年（早产A组）和2005～2009年（早产B组），比较不同时期早产发病状况、相关I临床因素及新生儿预后等情况。结果：①2000～2009年早产率平均为18．5％，从2000年的10．6％上升至2009年的26．1％。②Logistic回归分析，进入回归方程的有：胎膜早破（PROM）、妊娠期高血压疾病（PIH）、妇产科疾病既往史、多胎妊娠、自然流产次数、胎盘粘连、前置胎盘、胎盘早剥、妊娠期肝内胆汁淤积症、胎儿窘迫、妊娠期糖尿病、助孕技术及产检次数；其中早产B组妇产科疾病既往史、PIH、胎儿窘迫及多胎妊娠的构成比均高于早产A组（P〈0．05；P〈0．01）。③早产组新生儿体重、1分钟及5分钟Apgar评分均低于对照组（P〈0．01）；早产组新生儿死亡率和转科率均高于对照组（P〈0．01）；早产B组新生儿体重及死亡率均低于早产A组（P〈0．01）；早产B组转科率、新生儿1分钟及5分钟Apgar评分均高于早产A组（P〈0．05）。结论：我院近年来早产率明显上升，且与PROM、PIH、妇产科疾病既往史、多胎妊娠等多种临床因素有关。早产是新生儿死亡和预后不良的重要原因，近年来早产儿总体预后有所改善，应根据相关临床因素有针对性的加强早产预测和管理以减少早产的发生。
Objective：To analyze the changes in correlative conditions of premature delivery in Tongji hos- pital during 2000 ~ 2009 and to provide basis for prevention of preterm birth. Methods ：The clinical data of 2880 patients with premature delivery and 2880 patients with normal delivery in our hospital from Jan 2000 to Dec2009 were studied retrospectively. The patients with premature delivery were divided into group A（2000 2004） and group B（2005 -2009） to find the changes in incidence,correlative factors and neonatal prognosis during different periods. Results：①The average incidence of premature delivery was 18.5%,which gradually increased from 10.6% in 2000 to 26. 1% in 2009. ②The correlative clinical factors of premature delivery were PROM, PIH, history of obstetrical and gynecological diseases, multiple pregnancies,times of spontane- ous abortion, placenta adhesion, placenta previa, placenta abruption, ICP, fetal distress, GDM, use of assisted reproductive technology and the frequency of being examined during pregnancy. There were significant differ- ences between group A and group B when the incidence of PIH,fetal distress, history of obstetrical and gyne- cological diseases, and multiple pregnancies were compared （ P 〈 0.05; P 〈 0.01 ）.③The neonatal weight, one minute and five minute apgar score of the case group were significantly lower than those of the control group（P 〈 0.01 ）. The incidence of multiple pregnancies, neonatal mortality and transfer rate of the case group were significantly higher than those of control group（ P 〈 0.01 ）. The neonatal weight and mortality of group B were significantly lower than those of group A（ P 〈0.01 ）. The incidence of multiple pregnancies,one minute Apgar score,five minute Apgar score and transfer rate of group B were significantly higher than those of group A（ P 〈0.05）. Conclusions.The incidence of premature delivery was significantly increased during 2000 ~ 2009. Many factors such as PROM, PIH ,history of obstetrical and
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2014年第2期115-119,共5页
Journal of Practical Obstetrics and Gynecology
基金
国家自然科学基金(编号:30973205)
2013年国家十二五支撑项目(编号:2014BAI05B05)
关键词
早产
相关因素
危险因素
临床分析
回顾性分析
Premature birth
Correlative factors
Risk factors
Clinical analysis
Retrospective study
