【摘要】 目的探讨超高龄孕妇终止妊娠时机对母婴结局的影响。方法回顾性分析佛山市第一人民医院产科2016年2月至2019年1月160例超高龄孕妇分娩的资料,依据产妇分娩时妊娠周数分为超预产期妊娠组(40～41周,共33例)和正常足月妊娠组(37～39+6周,共127例)。对两组患者的年龄、距离前次妊娠时间、分娩前血红蛋白水平、产时体质量指数(BMI)等指标的组间比较采用t检验,对两组患者直接剖宫产、阴道试产失败后转剖宫产、阴道助产、顺产、产后出血、新生儿转儿科、羊水过少、羊水混浊、急性胎儿窘迫、胎膜早破、巨大儿的发生率的组间比较采用χ~2检验。结果超预产期妊娠组与正常足月妊娠组在年龄、距离前次妊娠时间、分娩前血红蛋白水平、产时BMI、直接剖宫产率、阴道试产失败后转剖宫产率、阴道助产率、顺产率、产后出血发生率、新生儿转儿科发生率、胎膜早破发生率、巨大儿发生率等方面差异无统计学意义(P均> 0.05)。超预产期妊娠组与正常足月妊娠组比较,羊水过少发生率(15.15%vs 3.15%,χ~2=5.026,P=0.025)、羊水混浊发生率(33.33%vs 3.15%,χ~2=24.648,P <0.001)、急性胎儿窘迫发生率(12.12%vs 1.57%,χ~2=5.414,P=0.020)均明显增高,差异有统计学意义。结论超高龄孕妇应选择足月后预产期前终止妊娠,降低发生围产儿不良结局的概率。更多还原

【Abstract】 Objective To investigate the maternal and fetal outcomes of super-advanced age pregnant women with different timing of pregnancy termination. Methods The data of 160 super-advanced age pregnant women who have labored at the First People Hospital of Foshan from February 2016 to January 2019 were retrospectively collected. The subjects were divided into either a post-term pregnancy group(n=33) or a term pregnancy group(n=127) based on the labor′s gestational age. The post-term pregnancy group had a gestational age between 40 and 41 weeks, and the term pregnancy group had a gestational ages between 37 and 39+ 6 weeks. Age, duration since previous pregnancy, hemoglobin levels before delivery, and body mass index at the labor′s gestational age were compared between the two groups by t-tests. Direct cesarean section rate, rate of conversion of vaginal trial to cesarean delivery, rate of vaginal midwifery, vaginal birth rate, postpartum hemorrhage rate, rate of neonatal admission, rate of oligohydramnios, rate of amniotic fluid turbidity, acute fetal distress rate, rate of premature rupture of membranes, and macrosomia rate were compared between the two groups by chi-square tests. Results There was no statistically significant difference between the two groups in age, duration since previous pregnancy, hemoglobin levels before delivery, body mass index at labor′s gestational ages, direct cesarean section rate, rate of conversion of vaginal trial to cesarean section, vaginal midwifery rate, vaginal birth rate, postpartum hemorrhage rate, rate of neonatal admission, rate of premature rupture of membranes, or incidence of macrosomia(P > 0.05), although oligohydramnios rate(15.15% vs 3.15%, χ~2=5.026, P=0.025), amniotic fluid turbidity rate(33.33% vs 3.15%, χ~2=24.648, P < 0.001), and acute fetal distress rate(12.12% vs 1.57%, χ~2=5.414, P=0.020) were statistically higher in the post-term pregnancy group than in the term pregnancy group. Conclusion Superadvanced pregnant women should undergo labor induction after the 37 weeks and before the expected date to reduce the probability of poor perinatal outcomes.更多还原