不良妊娠结局影响因素的研究

发布时间：2019-03-06 11:52

【摘要】：目的：通过调查孕产妇孕前保健和妊娠结局情况，了解不良妊娠结局发生率，探讨孕前保健对妊娠结局的影响，为加强孕前保健服务工作，降低不良妊娠结局的发生提供科学依据和有利数据支持。方法：本研究采用现况调查的方法，于2012年7月1日至2012年12月31日期间，在湖南省随机抽取的5个市级妇幼保健院和5个县级妇幼保健院住院分娩的产妇；调查内容：孕产妇、丈夫及家庭的一般情况、孕前保健情况、妊娠结局情况等。共发放1000份问卷，回收995份，最后有效问卷958份，有效率95.8%。使用Epidata3.1建立数据库，应用SPSS19.0进行统计分析。孕产妇一般情况及妊娠结局情况采用描述性统计分析，使用χ2检验对妊娠期高血压疾病、妊娠合并糖尿病、早产、病理妊娠引产和产后出血进行单因素分析；将单因素分析有统计学意义的因素进行多因素Logistic逐步回归分析。以ａ=0.05为检验水准。结果： 1.本次调查，妊娠期高血压疾病的发病率为12.2%，妊娠合并糖尿病的发病率为3.7%，早产的发生率为8.4%，病理妊娠引产的发生率为2.3%，产后出血的发生率为9.4%。 2.单因素χ2分析结果：母亲年龄、父母亲受教育程度、家庭收入水平、孕前保健咨询和孕前医学检查、父母亲孕前吸烟和饮酒、接触有毒有害物质、母亲孕前频繁接触动物、吸食毒品、母亲孕前肥胖、压力过大、患有疾病、是否接种疫苗以及孕前3个月内是否增补叶酸对不良妊娠结局的影响有统计学意义（Р＜0.05）。 3.多因素Logistic回归分析结果：高龄（OR=1.435）、有生育史（OR=1.938）、意外妊娠（OR=4.672）、频繁服用避孕药物（OR=2.576）为妊娠高血压疾病的危险因素；孕前被动吸烟回避（OR=0.314）是妊娠高血压的保护因素,城市孕产妇比农村（OR=0.580）的更易患妊娠期高血压疾病；孕产妇孕前饮酒（OR=2.338）、吸烟（OR=2.338）、孕前患有疾病（OR=2.761）、有过生育史（OR=2.379）是妊娠合并糖尿病的危险因素，被动吸烟主动回避（OR=0.384）是保护因素；丈夫孕前吸烟（OR=1.616）、孕产妇孕前频繁接触动物（OR=2.030）为早产的危险因素，孕前避免体重过低（OR=0.598）和家庭高收入（OR=0.642）是早产的保护因素；孕产妇孕前肥胖（OR=2.617）、患有疾病（OR=4.379）、孕产妇孕前吸烟（OR=6.667）、孕前频繁接触动物（OR=6.752）及丈夫孕前经常饮酒（OR=5.456）为病理妊娠引产的危险因素；孕产妇高学历（OR=0.385）及孕前增补叶酸（OR=0.102）为保护因素；孕产妇孕前6个月内进行医学检查（OR=0.634）、孕前被动吸烟回避（OR=0.464）是产后出血的保护因素，，孕产妇孕前患病（OR=1.701）、既往分娩史（OR=2.287）是产后出血的危险因素。结论： 1.妊娠期高血压疾病的发病率为12.2%，妊娠合并糖尿病的发病率为3.7%，早产的发生率为8.4%，病理妊娠引产的发生率为2.3%，产后出血的发生率为9.4%。 2.不良妊娠结局的主要影响因素有：母亲年龄、父母亲受教育程度、家庭收入水平、孕前保健咨询和孕前医学检查、父母亲孕前吸烟和饮酒、接触有毒有害物质、母亲孕前频繁接触动物、吸食毒品、母亲孕前肥胖、压力过大、患有疾病。
[Abstract]:Purpose: To investigate the incidence of adverse pregnancy outcome by investigating the maternal and maternal health and the outcome of the pregnancy, and to explore the effect of the pre-pregnancy health care on the outcome of the pregnancy, and to provide the scientific basis and data support for strengthening the pre-pregnancy health care service and reducing the occurrence of the adverse pregnancy outcome. Hold on. Method: The present study adopted the method of current status survey. During the period from July 1,2012 to December 31,2012, five levels of maternal and child health care and 5 maternal and child health care homes and five maternal and child health care homes were randomly selected in Hunan Province, and the survey was conducted. Capacity: General situation of pregnant women, husbands and families, pre-pregnancy care, pregnancy Outcome, etc. A total of 1000 questionnaires were issued,995 were recovered,958 in the last valid questionnaire and the effective rate 95.8%. Using Epidata3.1 to set up a database, apply SPSS19.0 The statistical analysis was performed on the general situation of the pregnant women and the outcome of the pregnancy, and the pregnancy-induced hypertension, the pregnancy and the diabetes, the premature birth, the induced labor of the pathological pregnancy and the postpartum hemorrhage were carried out by using the 2-2 test. single-factor analysis; multi-factor logistic analysis of single-factor analysis with statistical significance Step regression analysis. to test The results were as follows:1. The incidence of hypertension in pregnancy was 12.2%, the incidence of pregnancy with diabetes was 3.7%, the incidence of premature birth was 8.4%, and the incidence of induced labor in the pathological pregnancy was 2.3%, and the postpartum hemorrhage. The incidence rate was 9.4%.2. The results of single factor analysis 2: the age of the mother, the degree of education of the parents, the level of the family income, the pre-pregnancy care consultation and the pre-pregnancy medical examination, the pre-pregnancy smoking and drinking of the parents, the contact with the toxic and harmful substances, the frequent contact of the animals before the mother was pregnant, The effect of folic acid on the outcome of an adverse pregnancy is statistically significant in the case of a drug, a mother who is obese before the pregnancy, an excessive pressure, a disease, whether or not a vaccine is administered, and whether or not the addition of folic acid in the first 3 months of the pregnancy has an impact on the outcome of the poor pregnancy 3. Logistic regression analysis of multiple factors: The results of multi-factor logistic regression: the advanced age (OR = 1.435), the history of birth (OR = 1.938), the accidental pregnancy (OR = 4.672), the frequent use of the contraceptive (OR = 2.576) is the risk factor of the hypertensive disorder of the pregnancy; the passive smoking avoidance (OR = 0.31) 4) It is the protective factor of pregnancy and hypertension, and the ratio of urban and maternal to the rural (OR = 0.580) is more likely to be a pregnancy-induced hypertension disease; the pre-pregnancy alcohol consumption (OR = 2.338), smoking (OR = 2.338), the pre-pregnancy (OR = 2.761), and the history of pregnancy (OR = 2.379) are the risk factors of the pregnancy and the diabetes, and the active avoidance of passive smoking (O R = 0.384) was a protective factor; pre-pregnancy smoking (OR = 1.616), and frequent contact of the animals (OR = 2.030) to the risk factors for preterm birth, avoiding low body weight (OR = 0.598) and high family income (OR = 0.642) before pregnancy was a protective factor for preterm birth; pregestational obesity (OR = 2.617), risk of suffering There were diseases (OR = 4.379), pre-pregnancy smoking (OR = 6.667), pre-pregnancy frequent contact animals (OR = 6.752) and pre-pregnancy frequent alcohol consumption (OR = 5.456) as a risk factor for the induction of a pathological pregnancy; maternal high education (OR = 0.385) and pre-pregnancy supplementation of folic acid (O R = 0.102) was the protection factor; the medical examination (OR = 0.634) was performed within 6 months of the first pregnancy, and the passive smoking avoidance (OR = 0.464) was the protective factor for postpartum hemorrhage, the pre-pregnancy disease (OR = 1.701), and the history of previous delivery (OR = 2.2 87) The risk factors of postpartum hemorrhage were:1. The incidence of hypertension in pregnancy was 12.2%, the incidence of pregnancy with diabetes was 3.7%, the incidence of premature labor was 8.4%, and the incidence of induced labor in the pathological pregnancy was 2. 3%, the incidence of postpartum hemorrhage was 9.4%.2. The main influencing factors of the adverse pregnancy outcome were: the age of the mother, the level of education of the parents, the level of the family income, the pre-pregnancy care consultation and the pre-pregnancy medical examination, the pre-pregnancy smoking and the drinking of the parents, and the contact with the toxic substances. It's harmful to your mother. You're in contact with animals before you get pregnant.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R714.2

【参考文献】