【摘要】 目的分析全面两孩政策实施后高龄、经产孕产妇的母婴结局。方法选取2016年1月至2016年12月在福建省妇幼保健院分娩的16 195例孕产妇。根据孕产妇的年龄和产次,将其分为高龄初产妇组(396例)、高龄经产妇组(1 775例)、适龄经产妇组(5 731例),其他产妇8 293例,占比48.79%。采用回顾性分析比较高龄经产妇、高龄经产妇、适龄经产妇三组的分娩方式、妊娠并发症和新生儿结局。结果高龄经产妇组自然分娩率低于适龄经产妇组,却显著高于高龄初产妇组(P <0.05)。各组助产方式均以剖宫产的比例最高,且高龄经产妇组高于适龄经产妇组而低于高龄初产妇组(P <0.05),其余助产方式的发生率比较差异未见统计学意义(P> 0.05)。高龄经产妇的妊娠期高血压疾病、胎膜早破、胎盘粘连、羊水量异常的发生率均低于高龄初产妇组,差异有统计学意义(P <0.05);而子宫肌瘤、妊娠期高血压疾病、妊娠期糖尿病、前置胎盘以及胎膜早破的发生率高于适龄经产妇组,差异有统计学意义(P <0.05)。高龄初产妇的早产、胎儿生长受限、胎儿窘迫的发生率均高于高龄经产妇组(P <0.05);高龄经产妇组的胎儿窘迫发生率显著高于适龄经产妇组(P <0.05)。结论高龄、经产影响母婴结局,临床工作中要加强对高龄、经产妇妊娠期的监测与管理。更多还原

【Abstract】 Objective To analyze the maternal and infant outcomes of elderly,multiparous parturient women after the implementation of the comprehensive two child policy. Methods A total of 16195 pregnant women who gave birth in Fujian Maternal and Child Health Hospital from January to December in 2016 were selected. According to the age and times of delivery of pregnant women,they were divided into elderly primipara group( 396 cases),elderly parturient women group( 1775 cases),school-age parturient group( 5731 cases),and other primipara 8293 cases,accounting for 48. 79%.Retrospective analysis was used to compare the delivery methods,pregnancy complications and neonatal outcomes of elderly primipara,elderly postmenopausal women and school-age parturient. Results The natural delivery rate of the elderly parturient women group was lower than that of the school-age parturient group,but significantly higher than that of the elderly primipara group( P < 0. 05). The proportion of cesarean section was the highest in all groups,and that of the elderly parturient women group was higher than that of the school-age parturient women group and lower than that of the elderly primipara group( P < 0. 05). There was no significant difference in the incidence of other midwifery methods( P > 0. 05). The incidences of gestational hypertension,premature rupture of membranes,placental adhesion and abnormal amniotic fluid volume in the elderly parturient women group were significantly lower than those in the elderly primipara group( P < 0. 05). The incidences of uterine fibroids,hypertensive disorder complicating pregnancy,gestational diabetes mellitus,placenta previa and premature rupture of membranes in the elderly parturient women group were higher than those in the school-age parturient group, and the differences were significant( P < 0. 05). The incidences of premature delivery,fetal growth restriction and fetal distress in the elderly primipara group were higher than those in the elderly parturient women group( P < 0. 05). The incidence of fetal distress in the elderly parturient women group was significantly higher than that in the school-age parpurient women group( P < 0. 05). Conclusions Advanced age and childbirth can affect the outcome of mothers and infants. We should strengthen the monitoring and management of the elderly,multiparous parturient women during pregnancy.更多还原