兰州市不良妊娠结局发生率及病种顺位研究
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摘要
目的分析兰州市不良妊娠结局病种发生率及病种顺位,探讨不良妊娠结局的主要致病因素,为了解不良妊娠结局核心病种,控制不良妊娠结局的发生提供基础数据。方法以兰州市妇幼保健院2015—2018年出生的全部新生儿及孕产妇为研究对象。专业医护人员采用面对面访谈的方式,了解孕产妇在孕前、妊娠期暴露的各种因素,根据诊断标准记录新生儿的出生结局,计算不良妊娠结局发生率。结果兰州市不良妊娠结局发生率为14.12%。其中,早产儿、巨大儿、出生缺陷、足月小样儿发生率分别为5.07%、4.54%、2.57%、1.95%;早产儿、巨大儿、出生缺陷、足月小样儿的构成比分别为36%、32%、18%、14%;城市、农村不良妊娠结局的发生率分别为16.03%、9.34%;男、女婴不良妊娠结局发生率分别为15.60%、12.60%。试管婴儿、高龄孕产妇、妊娠高血压综合征不良妊娠结局发生率分别高于自然受孕、适龄孕产妇、非妊娠高血压综合征。结论不良妊娠结局病种顺位依次为早产儿、巨大儿、出生缺陷、足月小样儿。妊娠高血压综合征、高龄孕产妇、试管婴儿是不良妊娠结局的危险因素。
Objective To investigate the incidence rate, rank and risk factors of adverse pregnancy outcomes in Lanzhou City. To provide basic date for revealling the core diseases of adverse pregnancy outcomes and controlling it's occurrence in Lanzhou City. Methods Newborns and their mothers were selected at the Maternal and Child Health Center, Lanzhou proper from 2015 to 2018, as the investigating objects, to study the risk factors of in their pregnancy and pre-pregnancy process by seeing the medical staff face-to-face.According to the diagnostic criteria, the phenotypes and incidence rate of adverse pregnancy outcomes werecounted. Results The incidence rate of adverse pregnancy outcomes was 14.12% in Lanzhou City. In different phenotypes, the incidence rate of preterm in fant, macrosomia, birth defect and moderately low birth weight was respectively 5.07%, 4.54%, 2.57%, and 1.95%, the constituent ratio of these phenotypes in adverse pregnancy outcomes was 36%, 32%, 18% and 14%, respectively. The incidence rate of adverse pregnancy outcomes was 16.03% in urban and 9.34% in rural, 15.60% in male and 12.60% in female. The incidence rate of adverse pregnancy outcomes in the subgroups of test tube boby, aged parturient and pregnant hypertension was higher than the subgroups of normal pregnancy, normal parturient and non-pregnant hypertension.Conclusion The rank of phenotypes to adverse pregnancy outcomes are preterm in fant, macrosomia, birth defect and birth weight, test tube boby, aged parturient and pregnant hypertension are risk factors for the adverse pregnancy outcome in Lanzhou City.
Objective To investigate the incidence rate, rank and risk factors of adverse pregnancy outcomes in Lanzhou City. To provide basic date for revealling the core diseases of adverse pregnancy outcomes and controlling it's occurrence in Lanzhou City. Methods Newborns and their mothers were selected at the Maternal and Child Health Center, Lanzhou proper from 2015 to 2018, as the investigating objects, to study the risk factors of in their pregnancy and pre-pregnancy process by seeing the medical staff face-to-face.According to the diagnostic criteria, the phenotypes and incidence rate of adverse pregnancy outcomes werecounted. Results The incidence rate of adverse pregnancy outcomes was 14.12% in Lanzhou City. In different phenotypes, the incidence rate of preterm in fant, macrosomia, birth defect and moderately low birth weight was respectively 5.07%, 4.54%, 2.57%, and 1.95%, the constituent ratio of these phenotypes in adverse pregnancy outcomes was 36%, 32%, 18% and 14%, respectively. The incidence rate of adverse pregnancy outcomes was 16.03% in urban and 9.34% in rural, 15.60% in male and 12.60% in female. The incidence rate of adverse pregnancy outcomes in the subgroups of test tube boby, aged parturient and pregnant hypertension was higher than the subgroups of normal pregnancy, normal parturient and non-pregnant hypertension.Conclusion The rank of phenotypes to adverse pregnancy outcomes are preterm in fant, macrosomia, birth defect and birth weight, test tube boby, aged parturient and pregnant hypertension are risk factors for the adverse pregnancy outcome in Lanzhou City.
引文
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[12]杨惠娟,于莹,刘凯波,等.二胎政策放开对北京市早产儿发生率及结局的影响分析[J].中国妇幼保健, 2017,32(1):10—12
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[16] Li Guang-hui, Kong Li-jun, Li Zhi-wen, et al. Prevalence of macrosomia and its risk factors in china:a multicentre survey based on birth data involving 101 723 singleton term infants[J]. Paediatric&Perinatal Epidemiology, 2014, 28(4):345—350
[17]万里,朱萍.巨大儿对母婴健康不良影响的研究进展[J].中国计划生育和妇产科, 2018, 10(5):33—37
[18]赵玉梅,陈求珠,石秀风.三亚地区出生缺陷的发生率及其相关因素分析[J].中国优生与遗传杂志, 2018,1(26):99—100
[19]张立明,张秀敏,李波,等.吉林省0~5岁儿童出生缺陷抽样调查分析[J].吉林大学学报:医学版, 2018, 44(3):651—655
[20]唐红梅,孙晓艳,陈定华,等.嘉兴市出生缺陷监测结果分析[J].预防医学, 2018, 30(5):538—540
[21]刘凯,秦英,王治民,等.甘肃省人民医院2006—2015年围产儿出生缺陷发生率变化趋势[J].兰州大学学报:医学版, 2017, 43(4):51—55
[22]张笑天,郑晓瑛.从生物学角度认识中国出生缺陷[J].人口与发展, 2013, 19(3):72—76
[23]张金梅,李芬.不同年龄妊娠结局特点分析[J].实用妇科内分泌杂志:电子版, 2017, 28(4):91—92, 95
[24] Veneri D, Franchini M, Randon F, et al. Thrombocytopenias:a clinical point of view[J]. Blood Transfus, 2009,7(2):75—85
[25]周爱芬,赵瑾珠,章一鸣,等.武汉市妊娠期高血压疾病及其不良妊娠结局大样本流行病学分析[J].中国妇幼保健, 2013, 28(18):2957—2960
[26]郭瑶,杨金娜,于跃辉.妊娠高血压对早产儿近期影响研究[J].临床军医杂志, 2018, 46(2):216—217, 219
[27]张静,徐巍,严超英.试管早产儿早期并发症及治疗转归[J].中国当代儿科杂志, 2013, 15(7):569—571
[28] Vulliemoz NR, Mcveigh E, Kurinczuk J. In vitro fertilisation:perinatal risks and early childhood outcomes[J]. Human Fertility, 2012, 15(2):62—68
[29]米弘瑛,李利,麻新梅,等.试管婴儿新生儿情况分析[J].实用医学杂志, 2013, 29(4):593—594
[30]周保荣.重视孕期检查防治出生缺陷[J].中国妇幼卫生杂志, 2013, 1(4):73—74
[2]卞义华,王守林,于亮,等.某市2001—2008年不良妊娠结局的回顾性分析[J].中国妇幼保健, 2010, 25(33):4883—4887
[3] Traisrisilp K, Jaiprom J, Luewan S, et al. Pregnancy outcomes among mothers aged 15 years or less[J]. Journal of Obstetrics&Gynaecology Research, 2015, 41(11):1726—1731
[4] Anupama D, Laxmi M, Megha T. Importance of universal screening for thyroid disorders in first trimester of pregnancy[J]. Indian Journal of Endocrinology&Metabolism, 2014, 18(5):735—738
[5]王艳辉,刘艳平,卢淑丽.不良妊娠结局影响因素分析[J].预防医学, 2018, 30(3):303—305
[6]车洋洋,郭艳巍,王志宏,等.不良妊娠结局危险因素的巢式病例对照研究[J].中国妇幼保健, 2017, 32(2):230—233
[7]冯文霄.国内外出生缺陷的流行分布情况[J].中国妇幼保健, 2012, 27(10):1586—1589
[8]王卫平.儿科学[M].第8版.北京:人民卫生出版社,2013
[9]黄莉,张莉,李洪艳,等.孕产妇不良妊娠结局危险因素的巢式病例对照研究[J].中国现代医学杂志, 2015,25(9):106—109
[10]郑玉,朱焱,辛丽梅,等.贵州省农村育龄妇女不良妊娠结局现状及影响因素分析[J].现代预防医学,2018,45(2):247—250, 258
[11]喻欢,李红娟,郑凤仙,等.河南省新密市不良妊娠结局的分布和危险因素分析[J].中国妇幼保健, 2018,33(4):773—776
[12]杨惠娟,于莹,刘凯波,等.二胎政策放开对北京市早产儿发生率及结局的影响分析[J].中国妇幼保健, 2017,32(1):10—12
[13] Stacy B, Daniel W, Lale S, et al. The worldwide incidence of preterm birth:a systematic review of maternal mortality and morbidity[J]. Bull World Health Organ,2010, 88(1):31—38
[14]梁嬛,张为远,李笑天.基于巨大儿发生率的中国孕妇孕期体质量增加的参考范围:多中心横断面研究[J].中华妇产科杂志, 2017, 52(3):147—152
[15] Nkwabong E, Nzalli Tangho GR. Risk Factors for Macrosomia[J]. Journal of Obstetrics&Gynaecology of India, 2015, 65(4):226—229
[16] Li Guang-hui, Kong Li-jun, Li Zhi-wen, et al. Prevalence of macrosomia and its risk factors in china:a multicentre survey based on birth data involving 101 723 singleton term infants[J]. Paediatric&Perinatal Epidemiology, 2014, 28(4):345—350
[17]万里,朱萍.巨大儿对母婴健康不良影响的研究进展[J].中国计划生育和妇产科, 2018, 10(5):33—37
[18]赵玉梅,陈求珠,石秀风.三亚地区出生缺陷的发生率及其相关因素分析[J].中国优生与遗传杂志, 2018,1(26):99—100
[19]张立明,张秀敏,李波,等.吉林省0~5岁儿童出生缺陷抽样调查分析[J].吉林大学学报:医学版, 2018, 44(3):651—655
[20]唐红梅,孙晓艳,陈定华,等.嘉兴市出生缺陷监测结果分析[J].预防医学, 2018, 30(5):538—540
[21]刘凯,秦英,王治民,等.甘肃省人民医院2006—2015年围产儿出生缺陷发生率变化趋势[J].兰州大学学报:医学版, 2017, 43(4):51—55
[22]张笑天,郑晓瑛.从生物学角度认识中国出生缺陷[J].人口与发展, 2013, 19(3):72—76
[23]张金梅,李芬.不同年龄妊娠结局特点分析[J].实用妇科内分泌杂志:电子版, 2017, 28(4):91—92, 95
[24] Veneri D, Franchini M, Randon F, et al. Thrombocytopenias:a clinical point of view[J]. Blood Transfus, 2009,7(2):75—85
[25]周爱芬,赵瑾珠,章一鸣,等.武汉市妊娠期高血压疾病及其不良妊娠结局大样本流行病学分析[J].中国妇幼保健, 2013, 28(18):2957—2960
[26]郭瑶,杨金娜,于跃辉.妊娠高血压对早产儿近期影响研究[J].临床军医杂志, 2018, 46(2):216—217, 219
[27]张静,徐巍,严超英.试管早产儿早期并发症及治疗转归[J].中国当代儿科杂志, 2013, 15(7):569—571
[28] Vulliemoz NR, Mcveigh E, Kurinczuk J. In vitro fertilisation:perinatal risks and early childhood outcomes[J]. Human Fertility, 2012, 15(2):62—68
[29]米弘瑛,李利,麻新梅,等.试管婴儿新生儿情况分析[J].实用医学杂志, 2013, 29(4):593—594
[30]周保荣.重视孕期检查防治出生缺陷[J].中国妇幼卫生杂志, 2013, 1(4):73—74