不同类型早产相关因素对比分析

摘要

目的：探讨不同类型早产发生率、相关因素及妊娠结局。方法收集首都医科大学宣武医院妇产科2009年1月—2013年12月不同类型早产孕妇和新生儿的临床资料，对不同组别孕产妇（未足月胎膜早破组301例、未足月分娩组234例、医源性早产组193例）并发症发生情况、分娩方式、新生儿资料进行比较。结果2009—2013年早产率逐年增加，但差异无统计学意义（ P ＞0．05）。医源性早产组产妇年龄、剖宫产率、Apgar评分异常率及并发症明显高于未足月分娩组、未足月胎膜早破组（ P ＜0．05），而孕周、胎儿出生体质量低于未足月分娩组、未足月胎膜早破组（ P ＜0．05）；3组早产中经产妇和未进行过产前检查者明显高于初产妇和接受过产检者（ P ＜0．01），医源性早产组经产妇和未进行过产前检查的早产发生率高于未足月胎膜早破组和未足月分娩组（ P ＜0．05）。医源性早产中妊娠期高血压疾病患者高占67．36％（130／193），胎盘因素占15．54％（30／193），胎儿因素占7．77％（15／193），其他占9．33％（18／193）。结论早产率逐年增加，其中医源性早产、未足月胎膜早破是早产发生率增高的重要因素，而减少医源性早产对降低早产的发生率至关重要。%Objective To explore the different types of the premature delivery rate, related factors and pregnancy outcome.Methods From January 2009 to December 2013,clinical data different types of preterm birth pregnant women and neonates in department of gynecology and obstetrics,Xuanwu Hospital of Capital University of Medical Sciences were collected, for different groups of pregnant women ( preterm premature rupture of membranes group was 301 cases, preterm labor group was 234 cases, iatrogenic preterm group was 193 cases) , complications, mode of delivery and the data of the newborn were compared.Results From 2009 to 2013, complications and preterm birth rate were increased year by year.Iatrogenic preterm labor group’ s age,the rate of cesarean section maternal,Apgar score abnormal rate and complications were significantly higher than that of the preterm labor group and preterm premature rupture of membranes group ( P <0.05), and gestational age, birth weight were less than preterm delivery group, preterm premature rupture of membranes group ( P <0.05);3 groups of preterm’ s parous women and not carried out prenatal examination’ s women were obviously higher than that of primipara and received antenatal examination subjects ( P <0.01) , iatrogenic preterm group of preterm’ s parous women and not carried out prenatal examination’s women’ prenatal premature occurrence rate were higher than that of preterm premature rupture of membranes group and preterm delivery group ( P <0.05).Iatrogenic preterm delivery group’s patients with hypertensive dis-order were 67.36%(130/193), placental factors accounted for 15.54%(30/193), fetal factors accounted for 7.77%(15/193), the others was 9.33%(18/193).Conclusion Preterm birth rate has increased year by year, iatrogenic preterm birth, preterm premature rupture of membranes are important factor of preterm birth, while decrease the iatrogenic preterm labor is vital to reduce the rate of premature delivery.