妊娠晚期羊水过少影响妊娠结局的历史性队列研究
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摘要
目的:通过历史性队列研究分析妊娠晚期羊水过少对妊娠分娩结局的影响。方法:将住院分娩的孕妇按照年龄、孕周、分娩前体重、孕、产次等因素匹配,选取487例妊娠晚期羊水过少孕妇作为羊水过少组,620例羊水正常孕妇作为正常对照组,对比分析两组妊娠分娩结局的差异。结果:妊娠晚期羊水过少使孕妇剖宫产和脐带绕颈发生风险均明显增高,与正常对照组比较,相对危险度(RR)分别为4. 72(95%CI:3. 63～6. 14)和7. 58(95%CI:4. 08～15. 13);同时发生胎儿生长受限、羊水粪染、胎儿宫内窘迫和新生儿窒息风险升高,RR分别为4. 70(95%CI:2. 76～8. 31)、4. 72(95%CI:3. 63～6. 14)、4. 40(95%CI:3. 24～6. 02)和6. 20(95%CI:3. 74～10. 69)。结论:妊娠晚期羊水过少严重影响了围生儿健康,应加强产前定期检查和围生期保健,促进预后改善。
Objective To analyse oligohydramnios in late pregnancy on pregnancy outcomes was by historic cohort study.Method Pregnant women who were hospitalized in a District Central Hospital in Shanghai from May 2002 to April 2012,according to age,gestational age,weight before pregnancy matching factors,487 cases of pregnant women in late pregnancy oligohydramnios were selected as the exposed group,620 cases of normal amniotic fluid of pregnant women as the control group,The differences between the two groups of pregnancy outcomes were compared and analyzed. Results Compared with the normal control group, oligohydramnios in late pregnancy increased the risk of cord around the neck and cesarean delivery in pregnant women significantly,with RR of 4. 72( 95% CI: 3. 63 ～ 6. 14) and 7. 58( 95%CI: 4. 08 ～ 15. 13). Risk of fetal growth restriction,meconium-stained amniotic fluid,fetal distress and neonatal asphyxia was also increased,with RR of 4. 70( 95% CI: 2. 76 ～8. 31), 4. 72( 95% CI: 3. 63-6. 14), 4. 40( 95% CI: 3. 24 ～ 6. 02) and 6. 20( 95% CI: 3. 74 ～ 10. 69). Conclusion Trimester oligohydramnios seriously affected the health of perinatal children. Regular prenatal care and perinatal care should be strenthened,to promote prognosis.
Objective To analyse oligohydramnios in late pregnancy on pregnancy outcomes was by historic cohort study.Method Pregnant women who were hospitalized in a District Central Hospital in Shanghai from May 2002 to April 2012,according to age,gestational age,weight before pregnancy matching factors,487 cases of pregnant women in late pregnancy oligohydramnios were selected as the exposed group,620 cases of normal amniotic fluid of pregnant women as the control group,The differences between the two groups of pregnancy outcomes were compared and analyzed. Results Compared with the normal control group, oligohydramnios in late pregnancy increased the risk of cord around the neck and cesarean delivery in pregnant women significantly,with RR of 4. 72( 95% CI: 3. 63 ～ 6. 14) and 7. 58( 95%CI: 4. 08 ～ 15. 13). Risk of fetal growth restriction,meconium-stained amniotic fluid,fetal distress and neonatal asphyxia was also increased,with RR of 4. 70( 95% CI: 2. 76 ～8. 31), 4. 72( 95% CI: 3. 63-6. 14), 4. 40( 95% CI: 3. 24 ～ 6. 02) and 6. 20( 95% CI: 3. 74 ～ 10. 69). Conclusion Trimester oligohydramnios seriously affected the health of perinatal children. Regular prenatal care and perinatal care should be strenthened,to promote prognosis.
引文
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[2]王思思.妊娠晚期羊水过少与妊娠结局的临床分析[D].河北医科大学,2011.
[3]朱玉英,陈春燕. 108例妊娠晚期羊水过少的相关因素与妊娠结局的分析[J].医学临床研究,2007,24(4):629.
[4]吴学毅,尤奎成.妊娠合并羊水过少妊娠结局观察及产科处理[J].河北联合大学学报(医学版),2013,15(5):673.
[5]李乃伶.羊水过少100例母婴危害分析[J].基层医学论坛,2011,15(11):1013.
[6]廖洋,林进,李奇艳,等.不同程度羊水过少对晚期妊娠结局的影响研究[J].临床研究,2012,10(8):444.