上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2020, Vol. 40 ›› Issue (1): 58-.doi: 10.3969/j.issn.1674-8115.2020.01.009

• 论著·临床研究 • 上一篇    下一篇

高龄初产妇与高龄经产妇的妊娠结局比较

林 静1, 2，刘 含1, 2，刘欣梅1, 2，陈小君1，黄荷凤1, 2   

  1. 1. 上海交通大学医学院附属国际和平妇幼保健院，上海 200030；2. 上海胚胎源性疾病重点实验室，上海 200030
  • 出版日期:2020-01-28 发布日期:2020-03-05
  • 作者简介:林 静（1992—），女，住院医师，硕士；电子信箱：linjing1215@163.com。
  • 基金资助:
    国家重点研发计划（2018YFC1003200）；国家自然科学基金（81771593）。

Pregnancy outcome comparison between primiparas and multiparas with advanced maternal age

LIN Jing, LIU Han, LIU Xin-mei, CHEN Xiao-jun, HUANG He-feng   

  1. 1. International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030; 2. Shanghai Key Laboratory of Embryo Origianl Diseases, Shanghai 200030
  • Online:2020-01-28 Published:2020-03-05
  • Supported by:
    National Key Research and Development Program of China (2018YFC1003200); National Natural Science Foundation of China (81771593).

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摘要： 目的·探究高龄初产妇与高龄经产妇发生不良妊娠结局风险的差异。方法·按照回顾性队列研究设计，收集2014年1月—2016年12月于上海交通大学医学院附属国际和平妇幼保健院进行单胎分娩的6 129例高龄产妇，比较初产妇和经产妇（产次2）的妊娠结局差异，通过Logistic回归分析比较初产妇与经产妇发生不良妊娠结局的风险。结果·高龄初产妇发生胎膜早破（校正OR1.35，95% CI 1.18～1.54）、子痫前期/子痫（校正OR1.99，95% CI 1.45～2.73）、妊娠期糖尿病（校正OR1.32，95% CI 1.15～1.51）、小于胎龄儿（校正OR2.49，95% CI 1.78～3.48）和剖宫产（校正OR1.45，95% CI 1.30～1.62）等不良妊娠结局的风险高于经产妇。初产妇的新生儿出生体质量略低于经产妇。结论·高龄初产妇发生胎膜早破、子痫前期/子痫、妊娠期糖尿病、小于胎龄儿和剖宫产等不良妊娠结局的风险高于高龄经产妇。

关键词: 高龄妊娠, 初产妇, 经产妇, 妊娠结局

Abstract:

Objective · To explore the risk of adverse pregnancy outcomes in the primiparas and the multiparas with advanced maternal age. Methods · Through a retrospective cohort study, 6 129 elderly women who gave birth to a single child January 2014 to December 2016 in the International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine were collected to compare the differences in pregnancy outcomes between the primiparas and the multiparas (parity2). Logistic regression analysis was used to evaluate the risk of adverse pregnancy outcomes in the two groups of pregnant women. Results · Compared with the multiparas, the primiparas with advanced maternal age had a higher risk of premature rupture of membranes (adjusted OR1.35, 95% CI 1.18-1.54), preeclampsia/eclampsia (adjusted OR1.99, 95% CI 1.45-2.73), gestational diabetes mellitus (adjusted OR1.32, 95% CI 1.15-1.51), small-for-gestation age (adjusted OR2.49, 95% CI 1.78-3.48), and cesarean section (adjusted OR1.45, 95% CI 1.30-1.62). The birth weight of infants deliveredthe primiparas was slightly lower than that of the multiparas. Conclusion · In the advanced maternal age women, primiparas have a higher risk of adverse perinatal outcomes than multiparas, such as premature rupture of membranes, preeclampsia/eclampsia, gestational diabetes mellitus, small-for-gestation age and cesarean section.

Key words: advanced maternal age, primipara, multipara, pregnancy outcome