摘要
目的:探讨中晚孕期胎盘肥厚的影响因素及与母儿不良妊娠结局关系。方法:选择2020年1月-2023年10月本院产前检查妊娠20周后单胎孕妇,其中发现胎盘肥厚(>5.0 cm)111例作为病例组,胎盘厚度正常及轻度增厚(2.1~5.0cm)208例为对照组。采用二元logistic回归方法分析可能引起胎盘肥厚的独立危险因素,比较两组不良妊娠结局。结果:两组体质指数(BMI)、检查孕中/晚期、孕次、初产妇、辅助生殖、基础疾病/合并症(妊娠其糖尿病、高血压、贫血)、新生儿性别等指标无差异(P>0.05),病例组年龄、肥胖、存在胎盘血窦和胎盘厚度占比均高于对照组(P<0.05)。采用二元logistic回归分析显示,孕妇肥胖及胎盘存在血窦是中晚孕期胎盘肥厚的独立危险因素(P<0.05)。两组发生胎盘绒毛膜羊膜炎占比无差异(P>0.05),病例组出现早产(分娩<37周)、产后出血、胎盘早剥、围产期腹痛及出血、胎盘局灶性梗死及脐带插入点偏心或帆状插入占比均高于对照组(P<0.05)。结论:孕妇肥胖及胎盘出现血窦会增加中晚孕期胎盘增肥厚风险,胎盘肥厚可增加母儿不良妊娠结局。
Objective:To investigate the influencing factors of the placental hypertrophy of pregnant women during the second and the third trimester of pregnancy,and to study its correlation with the maternal and fetal adverse pregnancy outcomes.Methods:A total of 111 singleton pregnant women with placental hyperplasia(>5.0cm)after 20 gestational weeks who came to the hospital for antenatal examination were selected in observation group and 208 singleton pregnant women with normal or mild placental thickness(2.1-5.0cm)were selected in control group from January 2020 to October 2023.The independent risk factors could cause placental hypertrophy of the women were analyzed by binary logistic regression method.The adverse pregnancy outcomes of the women were compared between the two groups.Results:There were no significantly differences in the body mass index(BMI),the times of prenatal examination,the gravidity,the percentages of the primipara,the assisted reproduction technology used and the underlying diseases/complications(gestational diabetes mellitus and hypertension and anemia),and the neonatal gender of the women between the two groups(P>0.05).The age,the proportions of obesity and placental blood sinus,and the placental thickness of the women in the observation group were significantly higher than those of the women in the control group(P<0.05).Binary logistic regression analysis showed that the maternal obesity and the presence of the placental blood sinus of the women were the independent risk factors of their placental hypertrophy during the second and the third trimesters of pregnancy(P<0.05).There was no significant difference in the proportion of the placental chorioamnionitis of the women between the two groups(P>0.05).The proportions of the premature delivery(<37 gestational weeks at delivery),the postpartum hemorrhage,the placental abruption,the perinatal abdominal pain and bleeding,the placental focal infarction,and the eccentric or velamentous umbilical cord insertion of the women in the observation group were significantly higher than those of the women in the control group(P<0.05).Conclusion:The obesity and the presence of the placental blood sinus of the women increase the risk of their placental hypertrophy during the second and the third trimesters of pregnancy.The placental hypertrophy of the pregnant women during the second and the third trimesters of pregnancy can increase their adverse pregnancy outcomes.
作者
刘景雁
郭永华
张锐
LIU Jingyan;GUO Yonghua;ZHANG Rui(Daxing Teaching Hospital of Capital Medical University,Beijing,102600)
出处
《中国计划生育学杂志》
2025年第6期1431-1435,共5页
Chinese Journal of Family Planning
基金
北京市大兴区人民医院科研课题项目(4202301457)。
关键词
中孕期
晚孕期
胎盘厚度
影响因素
不良妊娠结局
The second trimesters of pregnancy
The third trimesters of pregnancy
Placental thickness
Influencing factor
Adverse pregnancyoutcomes
