高龄孕妇1005例临床特点和妊娠结局分析
徐帅;张媛;徐永萍;辛刚;武园歌;孙文娟;洪凡真;
摘要(Abstract)：
目的:探讨高龄孕妇的妊娠合并症、并发症、分娩方式及新生儿结局。方法:收集2017年1月1日至10月30日于山东大学第二医院住院分娩的1005例高龄孕妇。按年龄分组:35～40岁组、40～45岁组和≥45岁组,比较3组孕妇的临床资料。结果:高龄孕妇的分娩次数、子宫肌瘤和糖尿病的发病率与年龄呈显著正相关(P<0.05)。≥45岁组孕妇的羊水过多发生率(20.0%)、剖宫产率(90.0%)、足月低出生体重发生率(20.0%)、新生儿转入NICU占比(40.0%)明显高于35～40岁组(1.9%,62.3%,0.8%,12.4%)、40～45岁组(1.9%,62.3%,2.6%,17.5%)。年龄越大,妊娠期高血压疾病(HDCP)的发病率越高,差异均有统计学意义(P<0.05)。既往经阴分娩孕妇再次生育时,剖宫产率随年龄增长逐渐上升,差异均有统计学意义(P<0.05)。结论:加强高龄孕妇的孕期管理工作,对妊娠相关并发症做到早发现、早评估、早干预,指导选择合理的分娩方式,保障母儿安全。
关键词(KeyWords)： 妊娠并发症;年龄因素;妊娠结局
基金项目(Foundation): 山东省科技攻关项目“高龄孕妇孕期保健及妊娠结局的前瞻性研究”(No:2016GSF201098)
作者(Authors): 徐帅;张媛;徐永萍;辛刚;武园歌;孙文娟;洪凡真;
DOI: 10.13283/j.cnki.xdfckjz.2018.08.013
参考文献(References)：
- [1]谢幸,苟文丽.妇产科学[M].第8版.北京:人民卫生出版社,2013:58-220
- [2]Moaddab A,Chervenak FA,Mccullough LB,et al.Effect of advanced maternal age on maternal and neonatal outcomes in assisted reproductive technology pregnancies[J].Eur J Obstet Gynecol Reprod Biol,2017,216:178-183
- [3]Schimmel MS,Bromiker R,Hammerman C,et al.The effects of maternal age and Parity on maternal and neonatal outcome[J].Arch Gynecol Obstet,2015,291(4):793-798
- [4]王晨,王雪茵,杨慧霞,等.北京地区妇女分娩年龄与妊娠结局的关系[J].中华妇产科杂志,2017,52(8):514-520
- [5]Marozio L,Picardo E,Fili PPini C,et al.Maternal age over40 years and Pregnancy outcome:a hospital-based survey[J].Matern Fetal Neonatal Med,2017,7:1-7
- [6]Grotegut CA,Chisholm CA,Johnson LN,et al.Medical and obstetric complications among pregnant women aged 45 and older[J].PLo S One,2014,9(4):e96237
- [7]Ogawa K,Urayama KY,Tanigaki SJ,et al.Association between very advanced maternal age and adverse Pregnancy outcomes:a cross sectional Japanese study[J].BMC Preg Childbirth,2017,17(1):349
- [8]Yang H,Wei Y,Gao X,et al.Risk factors for gestational diabetes mellitus in Chinese women:a Prospective study of 16,286 Pregnant women in China[J].Diabet Med,2009,26(11):1099-1104
- [9]Mosca L,Benjamin EJ,Berra K,et al.Effectiveness-based guidelines for the Prevention of cardiovascular disease in women--2011 update:a guideline from the American Heart Association[J].J Am Coll Cardiol,2011,57(12):1404-1423
- [10]Lean SC,Heazell AEP,Dilworth MR,et al.Placental dysfunction underlies increased risk of fetal growth restriction and stillbirth in advanced maternal age women[J].Sci Rep,2017,7(1):9677
- [11]Markunas CA,Wilcox AJ,Xu ZL,et al.Maternal age at delivery is associated with an epigenetic signature in both newborns and adults[J].PLo S One,2016,11(7):e0156361
- [12]Fountoulakis KN,Gonda X,Siamouli M,et al.Paternal and maternal age as risk factors for schizophrenia:a case-control study[J].Int J Psychiatry Clin Pract,2017,25:1-7
- [13]Wu Y,Liu X,Luo H,et al.Advanced Paternal age increases the risk of schizophrenia and obsessive-compulsive disorder in a Chinese Han Population[J].Psychiatry Res,2012,198(3):353-359