阴道分娩产后出血发病率及影响因素的队列研究

发布时间：2018-04-05 07:40

本文选题：阴道分娩　切入点：产后出血(PPH)　出处：《中华生殖与避孕杂志》2017年10期

【摘要】：目的探讨上海市孕产妇阴道分娩产后出血相关的影响因素。方法将2015年6月—2016年5月期间在上海市4家医院首次建卡产检的孕妇纳入队列,随访至分娩,收集其建卡、初次产检和分娩的资料。计算阴道分娩产后出血的发生率,并用独立样本t检验或方差分析进行单因素分析,用多元线性回归分析探讨阴道分娩产后出血量的影响因素。结果共收集到阴道分娩孕产妇资料3 495份,产后出血(500 mL)发生率为1.5%(53/3 495),产后出血量平均为(255.6±156.4)mL。多元线性回归分析显示,产次每增加1次,产后出血量下降13.3 mL;合并妊娠期高血压疾病和分娩巨大儿分别可使产后出血量升高42.3 mL和22.3 mL。结论上海市孕产妇阴道分娩产后出血发生率较低,提倡孕期的合理增重有利于控制产后出血量,对于初产妇和合并妊娠期高血压疾病的孕妇应积极防范产后出血的发生。
[Abstract]:Objective to investigate the related factors of postpartum hemorrhage during vaginal delivery in Shanghai.Methods pregnant women in Shanghai from June 2015 to May 2016 were enrolled in a cohort of pregnant women who had their first birth check in four hospitals in Shanghai, and were followed up until delivery, and the data of building card, first birth examination and delivery were collected.The incidence of postpartum hemorrhage in vaginal delivery was calculated, and single factor analysis was carried out by independent sample t-test or variance analysis. The factors influencing the amount of postpartum hemorrhage in vaginal delivery were analyzed by multiple linear regression analysis.Results A total of 3 495 pregnant and parturient data of vaginal delivery were collected. The incidence of postpartum hemorrhage was 1. 5%. The average amount of postpartum hemorrhage was 255.6 卤156.4 mL.Multiple linear regression analysis showed that the volume of postpartum hemorrhage decreased by 13.3 mL with each increase of delivery time, and that the volume of postpartum hemorrhage increased by 42.3 mL and 22.3 mL respectively with hypertension complicating pregnancy and macrosomia.Conclusion the incidence of postpartum hemorrhage in vaginal delivery in Shanghai is relatively low, and the reasonable weight gain during pregnancy is beneficial to the control of postpartum hemorrhage. The occurrence of postpartum hemorrhage should be actively prevented for primipara and pregnant women with hypertension complicating pregnancy.
【作者单位】：复旦大学上海医学院;复旦大学生殖与发育研究院上海市计划生育科学研究所国家人口计生委计划生育药具重点实验室;浦东新区妇幼保健院;复旦大学附属妇产科医院;上海市第一人民医院;复旦大学附属中山医院青浦分院;
【基金】：国家自然科学基金(81472990)~~
【分类号】：R714.461

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