[1]翁艳,马萍,张雪,等.77例宫内死胎的相关危险因素分析[J].中国计划生育和妇产科,2017,(10):33-36.
　WENG Yan,MA Ping,ZHANG Xue,et al.Analysis of related risk factors of 77 cases of intrauterine stillbirth[J].Chinese Journal of Family Planning & Gynecotokology,2017,(10):33-36.
点击复制

77例宫内死胎的相关危险因素分析
分享到：

《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年10期
页码:
33-36
栏目:
论著与临床
出版日期:
2017-10-25

文章信息/Info

Title:
Analysis of related risk factors of 77 cases of intrauterine stillbirth
作者:
翁艳1; 马萍1; 张雪1; 薛芳1; 陈静2*;  阮英茆1
北京华信医院，1.病理科；2.妇产科
Author(s):
WENG Yan1; MA Ping1; ZHANG Xue1; XUE Fang1; CHEN Jing2*;  RUAN Ying-mao1
1. Department of Pathology; 2. Obstetrics and Gynecology，Beijing Huaxin Hospital，Beijing 100016，P.R.China
关键词:
宫内死胎; 危险因素;  妊娠; 胎儿
Keywords:
intrauterine stillbirth; risk factors; pregnancy; fetus
分类号:
R 7145
摘要:
目的探讨77例宫内死胎的相关危险因素。方法回顾性分析2004～2013年清华大学第一附属医院收治的宫内死胎产妇的临床病历资料（病例组），并随机选取同期200例单胎活产分娩产妇病历资料（对照组），采用多因素Logistic回归分析宫内死胎的危险因素。结果单因素结果显示，高龄（> 30岁）、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、无规律产检、羊水异常、胎儿发育异常的孕妇更易出现宫内死胎（P<005）；不同孕次、产次、流产史、妊娠期糖尿病的孕妇宫内死胎的发生率比较差异无统计学意义（P>005）；不同性别胎儿宫内死胎率比较差异无统计学意义（P>005）。多因素Logistic回归分析结果显示，高龄（> 30岁）、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、羊水异常、胎儿发育异常是宫内死胎的独立危险因素（OR分别为1675、1956、1863、1985、1677、1945、1954，P均<005）；规律产检是保护因素（OR=0542，P<005）。结论高龄（> 30岁）、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、羊水异常、胎儿发育异常是宫内死胎的独立危险因素，临床应重点关注高危人群，采取针对性措施进行干预。
Abstract:
ObjectiveTo explore the related risk factors of 77 intrauterine stillbirth.MethodsThe clinical data of 77 singleton intrauterine stillbirth in the First Affiliated Hospital of Tsinghua University from 2004 to 2013 as case group was retrospectively analyzed, and 200 singleton live births as control group were randomly selected. The risk factors of intrauterine stillbirth were analyzed by the multivariate logistic regression. ResultsThe univariate analysis showed that the pregnant women with advanced age(>30),gestational hypertension,placental abruption,placenta previa,umbilical cord abnormalities,irregular checkups,fetal amniotic fluid abnormalities or abnormal fetal development were more likely to have intrauterine stillbirth(P<005).There were no statistical significant differences on incidence of intrauterine stillbirths among pregnant women with different gestational age, birth, abortion history and gestational diabetes mellitus(P>005).No statistical difference on intrauterine stillbirths between fetal sexes(P>05).The multivariate logistic regression analysis showed that advanced age,gestational hypertension,placental abruption,placental previa,umbilical cord abnormalities,amniotic fluid abnormalities and fetal development abnormalities were the independent risk factors of intrauterine stillbirth (OR=1675、1956、1863、1985、1677、1945、1954,all P<005). Regular check-up was protective factor of intrauterine stillbirths (OR=0542, P<005).ConclusionAdvanced age(>30), hypertensive disorder complicating pregnancy, placental abruption, placenta previa, abnormal umbilical cord, amniotic fluid abnormalities and fetal development abnormalities are independent risk factors for intrauterine stillbirth.Clinical focus should be focused on high-risk groups and take targeted measures to intervene.

参考文献/References:

［1］Sharma S, Sidhu H, Kaur S. Analytical study of intrauterine fetal death cases and associated maternal conditions ［J］. Int J Appl Basic Med Res, 2016, 6(1): 11-13. ［2］Maignien C, Nguyen A, Dussaux C, et al. Outcome of pregnancy following second- or third-trimester intrauterine fetal death ［J］. International Journal of Gynecology & Obstetrics, 2014, 127(3): 275-278. ［3］张敏，黄启涛，钟梅，等．278例宫内死胎原因及临床特征分析 ［J］．实用妇产科杂志，2014，30 （2）：151-153． ［4］Tomson T, Battino D, Bonizzoni E, et al. Antiepileptic drugs and intrauterine death: A prospective observational study from EURAP ［J］. Neurology, 2015, 85(7): 580-588. ［5］Dudenhausen JW, Richter R, Vogel M. Stillbirths in the obstetrical departments of Berlin from 2013 to 2014［J］. Z Geburtshilfe Neonatol, 2016, 220(6): 257-260. ［6］Mutihir JT, Eka PO. Stillbirths at the Jos university teaching hospital: incidence, risk, and etiological factors ［J］. Niger J Clin Pract, 2011, 14(1): 14-18. ［7］Dimitrov G, Frandeva B, Garnizov T, et al. Causes of stillbirths according to the period of pregnancy ［J］. Akush Ginekol (Sofiia), 2014, 53(3): 3-7. ［8］Umazume T, Yamada T, Akaishi R, et al. Essential thrombocythemia as a risk factor for stillbirth ［J］. Thromb Res, 2014, 133(2): 158-161. ［9］Do Nascimento MI, Cunha AD, Dos Santos Muri Oliveira SR, et al. Misoprostol use under routine conditions for termination of pregnancies with intrauterine fetal death ［J］. Rev Assoc Med Bras, 2013, 59(4): 354-359. ［10］Christiansen-Lindquist L, Sahay K, Hogue CJ. Improving surveillance for the hidden half of fetal-infant mortality: a pilot study of the expansion of the Pregnancy Risk Assessment Monitoring System to include stillbirth ［J］. Ann Epidemiol, 2016, 26(6): 401-404. ［11］Shahul S, Tung A, Minhaj M, et al. Racial disparities in comorbidities, complications, and maternal and fetal outcomes in women with preeclampsia/eclampsia ［J］. Hypertension in Pregnancy, 2015, 34(4): 506-515. ［12］Leon MG, Moussa HN, Longo M, et al. Rate of gestational diabetes mellitus and pregnancy outcomes in patients with chronic hypertension ［J］. Am J Perinatol, 2016, 33(8): 745-750. ［13］Latif E, Adam S, Rungruang B, et al. Use of uterine artery embolization to prevent peripartum hemorrhage of placental abruption with fetal demise & severe DIC ［J］. J Neonatal Perinatal Med, 2016, 9(3): 325-331. ［14］CHEN K-h, Seow KM, CHEN L-r. The role of preterm placental calcification on assessing risks of stillbirth ［J］. Placenta, 2015, 36(9): 1039-1044. ［15］Kodama Y, Sameshima H, Yamashita R, et al. Intrapartum fetal heart rate patterns preceding terminal bradycardia in infants(>34 weeks)with poor neurological outcome:A regional population-based study in Japan ［J］. J Obstet Gynaecol Res, 2015, 41(11): 1738-1743. ［16］Broek CM,Bots J,Varela-Lasheras I,et al. Amniotic fluid deficiency and congenital abnormalities both influence fluctuating asymmetry in developing limbs of human deceased fetuses ［J］.PLoS One,2013,8 (11):e81824.

相似文献/References:

[1]乔宠,杨小梅,林其德,等.子痫前期的流行病学研究进展[J].中国计划生育和妇产科,2013,(06):0.
　QIAO Chong,YANG Xiao-mei,LIN Qi-de,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2013,(10):0.
[2]张蕾,朱兰.成年女性粪失禁流行病学调查研究现状[J].中国计划生育和妇产科,2014,(04):0.
[3]张艳梅,田野.妊娠合并急性胰腺炎的临床分析[J].中国计划生育和妇产科,2014,(08):0.
　ZHANG Yan-mei,TIAN Ye,[J].Chinese Journal of Family Planning & Gynecotokology,2014,(10):0.
[4]杨艳华,梁秀坤.严重产后出血致子宫切除原因及危险因素分析[J].中国计划生育和妇产科,2015,(11):0.
　YANG Yan-hua,LIANG Xiu-kun,[J].Chinese Journal of Family Planning & Gynecotokology,2015,(10):0.
[5]党淼.剖宫产术后影响子宫切口愈合不良的相关因素分析[J].中国计划生育和妇产科,2015,(11):0.
　DANG Miao,[J].Chinese Journal of Family Planning & Gynecotokology,2015,(10):0.
[6]王金光,乔宠,刘彩霞,等.双胎妊娠并发妊娠期高血压的危险因素[J].中国计划生育和妇产科,2016,(03):0.
[7]王声萍,张雅君,张红菱,等.武汉市围绝经期妇女压力性尿失禁患病率及影响因素的调查[J].中国计划生育和妇产科,2016,(04):0.
　WANG Sheng-ping,ZHANG Ya-jun,ZHANG Hong-ling,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2016,(10):0.
[8]林鑫子,黄晨玲子,罗新,等.剖宫产再次分娩子宫破裂相关危险因素的临床分析[J].中国计划生育和妇产科,2016,(07):0.
　LIN Xin-zi,HUANG Chen-lingzi,LUO Xin,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2016,(10):0.
[9]蒋镌,彭萍,刘欣燕,等.中孕期死胎的危险因素分析[J].中国计划生育和妇产科,2016,(11):0.
　JIANG Juan,PENG Ping,LIU Xin-yan,et al.[J].Chinese Journal of Family Planning & Gynecotokology,2016,(10):0.
[10]朱丽霞*,李耘.瘢痕子宫腹腔粘连危险因素分析及 对再次剖宫产的影响[J].中国计划生育和妇产科,2016,(12):47.
　ZHU Li-xia*,LI Yun.Risk factors of abdominal adhesions in scarred uterus and its influence on cesarean re-operation[J].Chinese Journal of Family Planning & Gynecotokology,2016,(10):47.

更新日期/Last Update: 2017-10-25