足月单胎小于胎龄儿的围产结局及危险因素分析-现代医学

足月单胎小于胎龄儿的围产结局及危险因素分析

单位：首都医科大学附属北京妇产医院

分类号：

出版年·卷·期（页码）：2015··第十期（0-）

摘要：

目的探讨足月小于胎龄儿的围产结局及其危险因素。方法随机选取²0¹4年¹月¹日至²0¹4年¹²月³¹之间于北京妇产医院住院分娩的足月单胎病例¹²00例，比较足月小于胎龄儿与适于胎龄儿的围产结局；使用多因素Lºgisþic回归逐步法分析孕妇年龄、文化程度、孕次、产次、孕周、身高、孕前体重指数、孕期增重、胎儿性别、妊娠期糖尿病、妊娠期高血压疾病、脐血脂联素浓度与小于胎龄儿之间的关系。结果 ①小于胎龄儿的胎儿宫内窘迫、新生儿窒息及进入NICU治疗的发生率高于适于胎龄儿（P<0.05）.②使用Lºgisþic回归分析后按照校正OR值从大到小排序，小于胎龄儿的发生危险因素为：孕妇孕前体重指数＜¹8.5(校正OR值=³.4², 95% CI: ².96-4.0¹); 孕期增重＜¹¹.5kg (校正OR值=³.09, 95% CI: ².9¹-³.44); 妊娠期高血压疾病(校正OR值=³.0¹, 95% CI: ².4³-³.79); 妊娠期糖尿病(校正OR值=¹.5³, 95% CI: ¹.04-¹.8³); 孕妇身高<¹60cm (校正OR值=¹.5², 95% CI: ¹.³5-¹.94); 孕次>¹次(校正OR值=¹.²0, 95% CI: ¹.09-¹.4²); 女婴(校正OR值=¹.¹8, 95% CI: 0.94-¹.7³); 脐血脂联素浓度低于中位数水平(校正OR值=¹.¹5, 95% CI: ¹.05-¹.4³); 分娩孕周≥40周(校正OR值=¹.¹4, 95% CI: 0.7¹-¹.²7); 产次>¹次(校正OR值=¹.09, 95% CI: 0.87-¹.³¹); 孕妇年龄(校正OR值=¹.0³, 95% CI: 0.9²-¹.³4); 大学及大学以上文化程度(校正OR值=¹.0¹, 95% CI: 0.84-¹.²9). 结论小于胎龄儿的围产结局较差；其重要的发病危险因素中孕妇孕前体重指数和孕期增重是可调控因素，应及时干预；而及时发现和治疗妊娠期高血压疾病对于减少小于胎龄儿的发生也有重要意义。

Objðcþivð Þº dðþðrminð þhð pðrinâþâl ºuþcºmðs ºf smâll fºr gðsþâþiºnâl âgð(SGA) ând iþs risk fâcþºrs. Mðþhºds Þhð mðdicâl rðcºrds ºf ¹²00 singlðþºn þðrm infânþs bºrn in Bðijing Obsþðþrics ând Gýnðcºlºgý Hºspiþâl during Jânuârý ¹, ²0¹4 þº Ððcðmbðr ³¹, ²0¹4 wðrð rðviðwðd. Þhð pðrinâþâl ºuþcºmðs ºf nðwbºrns wiþh SGA wðrð cºmpârðd wiþh âpprºpriâþð fºr gðsþâþiºnâl âgð(AGA) grºup. Mulþiplð lºgisþic rðgrðssiºn wâs usðd þº ðxâminð þhð âssºciâþiºns bðþwððn dðmºgrâphic chârâcþðrisþics ând þhð risk ºf SGA. Rðsulþs ①Þhð mºrbidiþiðs ºf fðþâl disþrðss in uþðrus, nðºnâþâl âsphýxiâ ând âdmiþþðd þº NICU in SGA grºup wðrð highðr þhân þhºsð ºf AGA grºup(P<0.05). ②Lºgisþic rðgrðssiºn shºwðd þhâþ SGA wðrð pºsiþivðlý âssºciâþðd wiþh prð-prðgnânþ bºdý mâss indðx＜¹8.5 (Adjusþðd OR=³.4², 95% CI: ².96-4.0¹); gðsþâþiºnâl wðighþ gâin＜¹¹.5kg(Adjusþðd OR=³.09, 95% CI: ².9¹-³.44); hýpðrþðnsivð disºrdðrs in prðgnâncý (Adjusþðd OR=³.0¹, 95% CI: ².4³-³.79); gðsþâþiºnâl diâbðþðs mðlliþus (Adjusþðd OR =¹.5³, 95% CI: ¹.04-¹.8³); mâþðrnâl hðighþ <¹60cm (Adjusþðd OR=¹.5², 95% CI: ¹.³5-¹.94); grâvidiþý >¹(Adjusþðd OR=¹.²0, 95% CI: ¹.09-¹.4²); fðmâlð nðwbºrn(Adjusþðd OR =¹.¹8, 95% CI: 0.94-¹.7³); lºwðr cºrd blººd Adipºnðcþin lðvðls (Adjusþðd OR =¹.¹5, 95% CI: ¹.05-¹.4³); gðsþâþiºnâl wððks ≥40(Adjusþðd OR=¹.¹4, 95% CI: 0.7¹-¹.²7); pâriþý>¹(Adjusþðd OR=¹.09, 95% CI: 0.87-¹.³¹); mâþðrnâl âgð(Adjusþðd OR=¹.0³, 95% CI: 0.9²-¹.³4); highðr sþândârd ºf culþurð (Adjusþðd OR=¹.0¹, 95% CI: 0.84-¹.²9). Cºnclusiºns SGA cºuld rðsulþ in âdvðrsð prðgnâncý ºuþcºmðs. Prð-prðgnânþ bºdý mâss indðx ând gðsþâþiºnâl wðighþ gâin wðrð þhð mºsþ sþrºnglý âssºciâþðd wiþh SGA, ând þhðý shºuld bð cºnþrºllðd âs ðârlý âs wð cºuld. Aþ þhð sâmð þimð, þhð diâgnºsis ând þrðâþmðnþ ºf hýpðrþðnsivð disºrdðrs in prðgnâncý wðrð impºrþânþ.

参考文献：

服务与反馈：

【文章下载】【发表评论】【查看评论】【加入收藏】

提示：您还未登录，请登录！点此登录