|本期目录/Table of Contents|

[1]丁丽丽,孟涛.高龄二胎产妇分娩方式选择及妊娠结局分析[J].医学研究与战创伤救治(原医学研究生学报),2020,22(3):245-248.[doi:10.3969/j.issn.1672-271X.2020.03.005]
　DING Li-li,MENG Tao.Delivery types and outcomes of pregnancy in advanced age women with second fetus[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2020,22(3):245-248.[doi:10.3969/j.issn.1672-271X.2020.03.005]
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高龄二胎产妇分娩方式选择及妊娠结局分析()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第22卷
期数:
2020年3期
页码:
245-248
栏目:
临床研究
出版日期:
2020-05-15

文章信息/Info

Title:
Delivery types and outcomes of pregnancy in advanced age women with second fetus
作者:
丁丽丽; 孟涛
作者单位：276800日照，日照市妇幼保健院妇产科（丁丽丽）;110000沈阳，中国医科大学附属医院儿科（孟涛）
Author(s):
DING Li-li;  MENG Tao
（1.Department of Gynecology and Obsterics, Maternal and Child Health Hospital of the Rizhao City, Rizhao 276800,Shandong, China; 2.Department of Pediatrics, Affiliated Hospital of China Medical University, Shenyang 110000, Liaoning, China）
关键词:
高龄产妇; 二胎; 分娩方式; 妊娠
Keywords:
advanced age;  second fetus;  delivery;  pregnancy
分类号:
R714.25
DOI:
10.3969/j.issn.1672-271X.2020.03.005
文献标志码:
A
摘要:
目的总结分析高龄二胎产妇分娩方式的选择及其影响因素以及妊娠结局。方法回顾性分析2017年1月至2019年12月在日照市妇幼保健院分娩的249例高龄二胎产妇临床资料，其中剖宫产组157例（63.1%），经阴道分娩组92例（36.9%），比较2组产妇临床特点及妊娠结局。结果剖宫产组产妇在年龄、既往剖宫产史、合并妊娠高血压及妊娠糖尿病的发生率[（38.7±2.7）岁、65.6%、16.6%、23.6%）]均较阴道分娩组[（37.3±2.3）岁、29.3%、6.6%、12.0%）]明显增高，差异有统计学意义（P<0.05）。多因素回归分析提示年龄(OR=2.44, 95%CI:1.42～4.57, P=0.014)、既往剖宫产史(OR=2.21, 95%CI:1.27～5.36, P=0.026)、妊娠高血压(OR=1.74, 95%CI:1.16～3.72, P=0.029)、收缩压升高(OR=1.45, 95%CI:1.11～2.48, P=0.035)以及三酰甘油升高(OR=1.38, 95%CI:1.08～1.75, P=0.041)是高龄二胎产妇选择剖宫产的影响因素。结论多种因素与高龄二胎产妇选择剖宫产有关，为改善分娩结局，应鼓励合适的产妇选择顺产方式。
Abstract:
ObjectiveTo summarize the clinical factors associated with the choice of delivery type and the outcomes of pregnancy in advanced age women with second fetus.Methods We retrospectively analyzed clinical data of advanced age women with second fetus in our center between Jan 2017 and Dec 2019. A total of 249 advanced women were enrolled into final analysis. Among these women, 157 (63.1%) received cesarean section (CS group, CSG), while the other 92 (36.9%) gave vaginal birth (VB group, VBG).ResultsIn CSG, 103 (65.6%) women were suitable to give vaginal birth. Compared with VBG, women in CSG were older (38.7±2.7 vs 37.3±2.3, P＜0.001) and had higher incidence of previous cesarean section (65.6% vs 29.3%, P＜0.001), gestational hypertension (16.6% vs 6.6%, P=0.022), gestational diabetes (23.6% vs 12.0%, P=0.025) and poorer outcome of pregnancy. Multiple factors logistic analysis revealed that age (OR=2.44, 95%CI:1.42-4.57, P=0.014), previous cesarean section (OR=2.21, 95%CI:1.27-5.36, P=0.026), gestational hypertension (OR=1.74, 95%CI:1.16-3.72, P=0.029), elevated systolic blood pressure (OR=1.45, 95%CI:1.11-2.48, P=0.035) and triglyceride (OR=1.38, 95%CI:1.08-1.75, P=0.041) were associated with the choice of cesarean section.ConclusionMultiple factors were associated with the choice of deliverytype. To improve the outcome of pregnancy in advanced age women, we should encourage selected individuals to give vaginal birth.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金 (81871173)
更新日期/Last Update: 2020-05-15