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胎儿生长受限危险因素及分娩时机的分析(1)
http://www.100md.com 2015年12月5日 中国医学创新 2015年第34期
     【摘要】 目的:探讨胎儿生长受限的相关危险因素及终止妊娠时机。方法:对2013年1月-2014年11月在郑州大学第三附属医院分娩的173例FGR新生儿(FGR组)及180例正常体重新生儿(对照组)及其产妇病历资料进行回顾性分析。结果:胎儿生长受限的高危因素有:妊娠期高血压疾病(P=0.000,OR=20.440,95%CI 8.499~49.156)、羊水过少(P=0.000,OR=5.652,95%CI 2.195~14.555)、妊娠期糖尿病(P=0.018,OR=2.763,95%CI 1.192~6.400)和贫血(P=0.032,OR=1.708,95%CI 1.047~2.786)。孕周越大,新生儿体重越重,预后越好,差异均有统计学意义(P<0.05)。结论:妊娠期高血压疾病、羊水过少、妊娠期糖尿病、贫血是胎儿生长受限的高危因素,加强孕期保健及监护,规范治疗产科并发症,适时终止妊娠是降低围产儿死亡率的主要措施。

    【关键词】 胎儿生长受限; 妊娠期高血压疾病; 羊水过少; 妊娠期糖尿病; 贫血
, 百拇医药
    Analysis of Risk Factors for Fetal Growth Restriction and Delivery Timing/CUI Shi-hong,SUN Jun-yan,CHEN Juan,et al.//Medical Innovation of China,2015,12(34):060-063

    【Abstract】 Objective:To explore the related risk factors for fetal growth restriction and time to termination of pregnancy. Method:The clinical data of 173 neonates with FGR(FGR group),180 neonates with normal weight(normal group) and the parturient women in the Third Affiliated Hospital of Zhengzhou University were selected from January 2013 to November 2014,they were analyzed retrospectively. Result:The high risk factors of fetal growth restriction were: gestational hypertension disease (P=0.000,OR=20.440,95%CI 8.499-49.156),oligohydramnios(P=0.000,OR=5.652,95%CI 2.195-14.555),gestational diabetes(P=0.018,OR=2.763,95%CI 1.192-6.400) and anemia(P=0.032,OR=1.708,95%CI 1.047-2.786).With the gestational age greater, the weight of the newborn was higher, the prognosis was better,the differences were statistically significant(P<0.05).Conclusion:Gestational hypertension disease, oligohydramnios, gestational diabetes and anemia are high risk factors of fetal growth restriction.To strengthen pregnancy care and custody,the standard treatment of obstetric complications, timely termination of pregnancy is main measures to reduce perinatal mortality.
, 百拇医药
    【Key words】 Fetal growth restriction; Gestational hypertension disease; Oligohydramnios; Gestational diabetes mellitus; Anemia

    First-author’s address:The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China

    doi:10.3969/j.issn.1674-4985.2015.34.019

    胎儿生长受限(Fetal Growth Ristriction,FGR),也称胎儿宫内生长受限(IUGR),指无法达到应有生长潜力的小于胎龄儿[1]。在我国其发病率平均为3%~7%,美国发病率为3%~10%。FGR胎儿的围产期死亡率为正常胎儿的4~6倍,占围产儿死亡总数的42.3%[2]。FGR可增加围产儿死亡率、发病率,宫内死亡,产时并发症,以及医源性早产(34周前的妊娠)[3]。本文旨在通过对353例临床病例进行分析,探讨FGR发生的相关危险因素和不同分娩孕周对围产儿结局的影响,提高产科质量。

    1 资料与方法

    1.1 一般资料 选取郑州大学第三附属医院2013年

    1月-2014年11月分娩的单胎、活产、无畸形的FGR患者173例为FGR组,孕妇年龄17~46岁,平均(29.76±0.438)岁,其中合并贫血93例,妊娠期高血压疾病71例,羊水过少29例,合并妊娠期糖尿病23例,胎盘异常18例,脐带异常5例,子宫形态异常1例,妊娠合并甲状腺功能亢进1例,血小板减少1例,部分患者甚至同时合并2~3种疾病。随机选取同期住院同种族、单胎、活产、无畸形、新生儿体质量正常的患者180例,作为对照组。, http://www.100md.com(崔世红 孙俊燕 陈娟 李园园 杭中霞 申琳娜 职云晓 高亚南)
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