高龄经产妇巨大儿相关因素及妊娠结局分析.docVIP

高龄经产妇巨大儿相关因素及妊娠结局分析 　　[摘要] 目的 探讨二胎政策下高龄经产妇分娩巨大儿的相关因素及妊娠结局。方法 回顾性分析2015年10月― 2016年9月在郑州大学第三附属医院（以下简称“该院”） 分娩巨大儿（胎儿出生体重≥4 000 g）的112例高龄经产妇的分娩资料作为研究组， 并与同期分娩正常体重儿（2 500 g≤出生体重4 000 g）的1 102例高龄经产妇的分娩资料作为对照组，比较两组临床资料及妊娠结局情况。结果 研究组分娩孕龄、产次、妊娠期糖尿病发生率分别为（39.27±1.03）周、（2.49±0.68）次、13.39%，明显高于对照组的（38.47±1.73）周、（2.18±0.48）次、6.17%；而研究组产检≥5次为72.32%，低于对照组的80.76%；研究组新生儿窒息、胎儿窘迫发生率，经阴道分娩者的总产程、产时及产后2 h出血量、羊水量均高于对照组；差异有统计学意义（P0.05）。结论 二胎政策开放后，高龄经产妇增加，应加强对高龄经产妇的管理，针对其分娩巨大儿的高危因素，指导合理饮食，适当活动，控制体重增长过速，定时产检，降低巨大儿发生率，并选择合适分娩方式，改善母婴结局。 　　[关键词] 高龄；经产妇； 巨大儿；相关因素；妊娠结局 　　[中图分类号] R714 [文献标识码] A [文章编号] 1674-0742（2017）05（b）-0060-04 　　[Abstract] Objective To study the related factors and pregnant outcome of giant babies delivered by the elder primipara under the two children policy. Methods 112 cases of elder primipara giving birth to the giant babies （birth weight≥4 000 g） in our hospital from October 2015 to September 2016 were selected as the research group， while 1 102 cases of elder primipara giving birth to the normal-weight children（2 500 g≤birth weight4 000 g） at the same period were selected as the control group， and the clinical data and pregnant outcome situation were compared between the two groups. Results The delivery pregnant age， parity and incidence rate of diabetes during the pregnancy period in the research group were obviously higher than those in the control group[（39.27±1.03）weeks， （2.49±0.68）times， 13.39% vs （38.47±1.73）weeks， （2.18±0.48）times， 6.17%]， but the antenatal care ≥5 in the research group was lower than that in the control group（72.32% vs 80.76%）， and the incidence rate of neonatal asphyxia and fetal distress， total labor course and labor time of vaginal delivery women and bleeding amount and amniotic fluid volume during 2 hours after labor in the research group were higher than those in the control group， and the differences between groups were statistically significant（P0.05）. Conclusion After the release of two-children policy， the elder primipara increase， a