论文部分内容阅读
目的:分析孕前检查联合规范化孕期保健在高龄产妇中的应用及对妊娠结局的影响。方法:选取2018 年 9 月至 2019 年 9月在石河子大学医学院第一附属医院围产门诊就诊的孕妇300例，根据其孕前及孕期检查情况分为三组，观察组（n n=78例）：孕前及孕期检查均按时、规律检查；对照1组（n n=110例）：既未行孕前检查同时孕期未规律产检；对照2组（n n=112例）：孕妇孕前检查或孕期规律产检（孕前及孕期检查有且仅有一项按规定检查）。对三组孕妇追踪其临床结局，并进行对照分析，探索高龄孕产妇孕前及孕期检查与妊娠期高血压疾病、妊娠期糖尿病、早产等多种妊娠风险之间的关系。n 结果:对照1组、对照2组、观察组早产（20.5％、9.8％、2.7％）、妊娠期高血压疾病（23.1％、12.5％、3.6％）、妊娠期糖尿病（19.2％、8.9％、2.7％）、胎膜早破（17.9％、10.7％、3.6％）、产后出血（12.8％、8.0％、1.8％）、妊娠期贫血（19.2％、8.0％、 2.7％）及胎盘早剥（7.7％、8.0％、0.9％）发生率差异均有统计学意义（χn 2=16.047、16.376、14.724、10.489、8.781、15.380、6.744，均n P<0.05）。对照1组、对照2组、观察组剖宫产率（70.5％、44.6％、27.3％）差异有统计学意义（χn 2=34.468，n P<0.05）。对照1组、对照2组、观察组新生儿中巨大儿（15.4％、8.9％、2.7％）、低体质量儿（11.5％、5.4％、0.0％）、死胎或晚期流产（10.3％、 4.7％、0.9％）、新生儿窒息（16.7％、7.1％、1.8％）发生率差异均有统计学意义（χn 2=9.654、12.840、8.979、14.284，均n P<0.05）。n 结论:高龄孕产妇妊娠不良结局的风险增加，孕前检查联合规范化孕期保健可明显改善高龄孕产妇的母婴结局。“,”Objective:To investigate the effects of pre-pregnancy health examination combined with standardized health care during pregnancy on the pregnancy outcome at advanced maternal age.Methods:A total of 300 pregnant women who visited the Perinatal Clinic of the First Affiliated Hospital, School of Medicine, Shihezi University, China who received treatment between September 2018 and September 2019 were included in this study. They were divided into three groups according to pre-pregnancy health examination and heath care during pregnancy. In the observation group (n n = 78), pregnant women received pre-pregnancy health examination and health care during pregnancy on time and regularly. In the control group 1 (n n = 110): pregnant women did not receive pre-pregnancy health examination or regular health care during pregnancy. In the control group 2 (n n = 112), pregnant women received pre-pregnancy health examination or regular heath care during pregnancy. The pregnancy outcome was compared among three groups. The pre-pregnancy health examination and regular health care during pregnancy in women at advanced maternal age were correlated with gestational hypertension, gestational diabetes mellitus, premature delivery and other pregnancy risks.n Results:There were significant differences in premature delivery (20.5%, 9.8%, 2.7%), gestational hypertension (23.1%, 12.5%, 3.6%), gestational diabetes mellitus (19.2%, 8.9%, 2.7%), premature rupture of membrane (17.9%, 10.7%, 3.6%), postpartum hemorrhage (12.8%, 8.0%, 1.8%), gestational anemia (19.2%, 8.0%, 2.7%) and placental abruption (7.7%, 8.0%, 0.9%) among control group 1, control group 2, and observation group (n χ2 = 16.047, 16.376, 14.724, 10.489, 8.781, 15.380, 6.744, all n P < 0.05). The rate of cesarean section rate in the control group 1, control group 2, and observation group was statistically significant (70.5%, 44.6% and 27.3%, n χ2 = 34.468, n P < 0.05). There were significant differences in the incidence rates of macrosomia (15.4%, 8.9%, 2.7%), low birth weight infants (11.5%, 5.4%, 0.0%), stillbirth or late-term abortion (10.3%, 4.7%, 0.9%), neonatal asphyxia (16.7%, 7.1%, 1.8%) among the control group 1, control group 2 and observation group ( n χ2 = 9.654, 12.840, 8.979, 14.284, all n P < 0.05).n Conclusion:The risk of adverse pregnancy outcomes is increased at advanced maternal age. Pre-pregnancy health examination combined with standardized health care during pregnancy can improve the pregnancy outcomes at advanced maternal age.