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高龄双胎妊娠的围产结局分析(1)
http://www.100md.com 2010年1月1日 陈敏玲 王子莲 凌家炜 韩振艳
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     【摘要】 目的 探讨高龄双胎妊娠的围产结局。方法 回顾性分析我院69例高龄双胎病例,随机对照176例非高龄双胎的临床资料,比较两组在妊娠并发症、妊娠合并症、和胎儿预后等方面的差异。结果 ①高龄组接受辅助生育技术受孕比例显著高于非高龄对照组(P<0.05);②高龄组<32孕周早产发生率明显高于对照组(P<0.05),而其他并发症及合并症两组间未见显著性差异;③高龄组以极低出生体重儿(<1500 g)比例显著高于对照组(P<0.05)。高龄组新生儿窒息率及胎儿窘迫发生率明显增高(P<0.05)。结论 高龄双胎妊娠不良妊娠结局主要与<32孕周的严重早产、极低体重儿、新生儿窒息及胎儿窘迫密切相关,应针对性加强高龄双胎的围生期监护,警惕严重早产的发生。

    【关键词】

    双胎妊娠;高龄;妊娠结局

    Perinatal outcomes in women aged 35 and over with twin pregnancy

    CHEN Minling,WANG Zilian,LING Jiahui,et al.Fetal Medicine Center,Department of Obstetrics and Gynecology,First Affiliated Hospital,Sun Yatsen University,Guangzhou 510080,China

    【Abstract】 Objective The aim of this study is to present perinatal outcomes of twin gestations in older women.Methods We conducted a retrospective cohort study of 69 cases of twin pregnancies maternal age 35 years and older(study group)in our department,compared with 176 twin pregnancies cases of maternal age less than 35 years(control group).Results ①Conceptions after assisted reproductive technology were significantly higher in study group(P<0.05).②The rate of preterm labour lower than 32 gestational weeks was significantly higher in the study group(P<0.05).The other complications rate did not differ singnificantly from the control groups.(3)The very low birth weight(VLBW<1,500 g)rate was significantly higher in the study group(P<0.05),the rate of neonatal asphyxia and fetal distress were statistically significant higher in study group(P<0.05).Conclusion Advanced maternal age was related with higher incidence of the severe preterm labour(<32 gestational weeks),the very low birth weight(<1,500 g),fetal distress,neonatal asphyxia.It is important to close monitoring during perinatal period in women aged 35 and over with twin pregnancy,watch out for the severe preterm labour..

    【Key words】

    Twin pregnancy; Older women;Perinatal outcome

    DOI:10.3760/cma.j.issn 16738799.2010.01.11

    作者单位:510080广州,中山大学附属第一医院妇产科胎儿医学中心

    由于社会经济的发展和职业妇女推迟生育等因素,近年高龄产妇比例明显升高,因此高龄双胎孕妇的围产结局受到日益重视,国内对此报道不多。本文总结2002年至2007年5年间在我院分娩的高龄双胎病例,对照非高龄组病例,分析其妊娠合并症与并发症及其他因素对分娩结局和新生儿的影响,为改善高龄双胎孕妇的妊娠结局提供参考 ......

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