巨大儿发生相关因素及分娩方式研究.docVIP

巨大儿发生相关因素及分娩方式研究 　　【第一作者简介】梁丽红（1980-），女，主治医师，主要从事妇产科临床诊治与研究工作。 　　【摘要】目的:通过对2007年至2011年在我院出生的640例巨大儿的的分娩方式、危险因素、产后并发症的分析，探讨巨大儿的产前预测及分娩方式，以减少分娩过程中的并发症。方法:收集2007年至2011年在我院出生的640例巨大儿和320例正常新生儿进行回顾性研究，计算巨大儿的发生率、剖宫产率等指标，并采用χ2检验对比各体重阶段新生儿分娩所产生的产后并发症是否存在差异，用非条件logistic回归分析巨大儿产生的危险因素。结果:2007年至2011年巨大儿发生率基本保持稳定，平均为6??81%，巨大儿的剖腹产率呈逐年上升趋势，顺产率呈逐年下降趋势；采用非条件logistic回归模型筛选，共筛选出妊娠期糖尿病、孕期体重、过期妊娠、新生儿性别、母亲年龄5个危险因素（P0??05）；各种体重分组间差异均具有统计学意义（P0??05），根据各种合并症的发生率情况，出生婴儿体重越大，发生妊娠合并症的风险越大。结论:妊娠期糖尿病、孕期体重、过期妊娠、新生儿性别、母亲年龄是巨大儿发生的高位因素，出生婴儿体重越大，发生妊娠合并症的风险越大，对于巨大儿应该多采取剖宫产的分娩方式。 　　【关键词】巨大儿；危险因素；妊娠合并症；剖宫产 　　Related factors and delivery mode of macrosomiaLIANG Lihong, PENG Laiqin, ZENG Yunying, MO Yilin, LIANG Duoxian. Department of Obstetrics and Gynecology, Huizhou Municipal Central Hospital, Huizhou 516000, China 　　【Abstract】Objectives: Through the analysis of the delivery mode, postpartum complications, risk factors of 640 macrosomia in our hospital from 2007 to 2011, to investigate the antenatal prediction and delivery mode of macrosomia so as to reduce complications during delivery process. Methods: 640 macrosomia and 320 normal neonates from 2007 to 2011 in our hospital were selected to conduct retrospective study to calculate incidence rate of cesarean section and macrosomia. The postpartum complications of newborn at different weight stages were examined and compared by chi-square test. Results: The incidence rate of macrosomia from 2007 to 2001 remained stable with an average of 6.81%. Cesarean section rate of macrosomia increased year by year, while natural delivery rate decreased; six risk factors, such as gestational diabetes, gestational weight, post-term pregnancy, newborn sex and age of mother, were selected by unconditional regression model (p0.05). Differences between groups of various weights were of statistical significance. Conclusion: Gestational diabetes, pregnancy weight, post-term pregnancy, newborn sex and maternal age are high risk factors of macrosomia. The higher wei