昆明地区妇女生育间隔对妊娠结局的影响
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摘要
目的探讨昆明地区妇女生育间隔(IPI)对妊娠结局的影响,为再生育妇女孕前咨询及政府制定公共卫生政策提供科学依据。方法选取2005年1月~2013年12月在昆明医科大学第一附属医院定期产检并分娩的2 119例单胎妊娠经产妇作为研究对象,回顾分析IPI与妊娠结局的关系。结果研究期间经产妇比例由2005年的10.1%逐渐上升至2013年的19.7%,研究人群平均IPI为(68.3±1.1)个月。妊娠期糖尿病(GDM)发生率自IPI为72个月后显著增加,子痫前期发生率自IPI为48个月后显著增加。校正母亲年龄等混淆因素后,GDM患病风险自IPI为72个月后仍然升高;子痫前期的风险从IPI为48个月后依然增加。但IPI对大于胎龄儿(LGA)、小于胎龄儿(SGA)和早产结局无显著影响。结论较长的IPI与GDM和子痫前期发生风险增加相关,可为再生育妇女孕前咨询以及政府制定公共卫生政策提供科学依据。
Objective:To explore the effect of interpregnancy interval(IPI) of the women of childbearing age on pregnancy outcome in Kunming,provide scientific basis for preconceptional counseling of multiparous women and the government to make public health policies.Methods:A total of 2 119 multiparous women of singleton pregnancy who received regular prenatal examination and gave birth to their babies in the hospital from January 2005 to December 2013 were selected,the relationship between IPI and pregnancy outcome was analyzed retrospectively.Results:The proportion of multiparous women increased gradually from 10.1% in 2005 to 19.7% in 2013,the mean IPI was(68.3±1.1) months.The incidence rate of gestational diabetes mellitus(GDM) increased significantly when IPI was longer than 72 months,the incidence rate of preeclampsia increased significantly when IPI was longer than 48 months.After adjusting the confounding factors,such as maternal age,the risk of GDM still increased when IPI was longer than 72 months; the risk of preeclampsia still increased when IPI was longer than 48 months.But IPI had no significant impact on large for gestational age infants,small for gestational age infants,and outcome of premature infants.Conclusion:Long IPI is associated with high risk of GDM and preeclampsia,which can provide scientific basis for preconceptional counseling of multiparous women and the government to make public health policies.
Objective:To explore the effect of interpregnancy interval(IPI) of the women of childbearing age on pregnancy outcome in Kunming,provide scientific basis for preconceptional counseling of multiparous women and the government to make public health policies.Methods:A total of 2 119 multiparous women of singleton pregnancy who received regular prenatal examination and gave birth to their babies in the hospital from January 2005 to December 2013 were selected,the relationship between IPI and pregnancy outcome was analyzed retrospectively.Results:The proportion of multiparous women increased gradually from 10.1% in 2005 to 19.7% in 2013,the mean IPI was(68.3±1.1) months.The incidence rate of gestational diabetes mellitus(GDM) increased significantly when IPI was longer than 72 months,the incidence rate of preeclampsia increased significantly when IPI was longer than 48 months.After adjusting the confounding factors,such as maternal age,the risk of GDM still increased when IPI was longer than 72 months; the risk of preeclampsia still increased when IPI was longer than 48 months.But IPI had no significant impact on large for gestational age infants,small for gestational age infants,and outcome of premature infants.Conclusion:Long IPI is associated with high risk of GDM and preeclampsia,which can provide scientific basis for preconceptional counseling of multiparous women and the government to make public health policies.
引文
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6 Li N,Liu E,Guo J,et al.Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes[J].PLo S One,2013,8(12):e82310.
7 Conde-Agudelo A,Rosas-Bermudez A,Kafury-Goeta AC.Effects of birth spacing on maternal health:asystematic review.Am J Obstet Gynecol,2007,196:297-308.
8 Dekker GA.Risk factors for preeclampsia[J].Clin Obstet Gynecol,1999,42(3):422-35.
9 Lie RT,Rasmussen S,Brunborg H,et al.Fetal and maternal contributions to risk of pre-eclampsia:popu-lation based study[J].Br Med J,1998,316(7141):1343-7.
2 Amanda W,Cassandra MG,Stacey P,et al.Impact of Increasing Inter-pregnancy Interval on Maternal and Infant Health[J].Paediatric and Perinatal Epidemiology,2012,26 (Suppl 1):239-58.
3 Ventura SJ,Martin JA,Curtin SC,Mathews TJ.Report of final natality statistics,1995.Mon Vital Stat Rep,1997,45:Suppl.
4 Conde-Agudelo A,Belizan JM,Norton MH,et al.Effect of the interpregnancy interval on perinatal outcomes in Latin America[J].Obstet Gynecol,2005,106(2):359-66.
5 Shachar BZ,Lyell DJ.Interpregnancy interval and obstetrical complications.Obstet Gynecol Surv,2012,67:584-596.
6 Li N,Liu E,Guo J,et al.Maternal Prepregnancy Body Mass Index and Gestational Weight Gain on Pregnancy Outcomes[J].PLo S One,2013,8(12):e82310.
7 Conde-Agudelo A,Rosas-Bermudez A,Kafury-Goeta AC.Effects of birth spacing on maternal health:asystematic review.Am J Obstet Gynecol,2007,196:297-308.
8 Dekker GA.Risk factors for preeclampsia[J].Clin Obstet Gynecol,1999,42(3):422-35.
9 Lie RT,Rasmussen S,Brunborg H,et al.Fetal and maternal contributions to risk of pre-eclampsia:popu-lation based study[J].Br Med J,1998,316(7141):1343-7.