高龄妊娠晚期孕妇心电图变化与妊娠结局的研究

目的 探讨妊娠晚期高龄孕妇异常心电图变化与其对妊娠结局的影响.方法 选取2014年1月至2016年6月在杭州市西溪医院进行产检及分娩的130例妊娠晚期孕妇,按照年龄分组,其中65例(年龄≥35岁)高龄孕妇为观察组,另选取65例(年龄<35岁)适龄孕妇为对照组.观察两组孕妇异常心电图发生率及心律失常类型;分析两组孕妇妊娠结局与异常心电图的关系.结果 观察组孕妇异常心电图发生率(32.31%)显著高于对照组(15.38%),χ2=5.125,P=0.024,差异有统计学意义(P<0.05);其中同时观察组心律失常(26.15%)、ST-T改变(12.31%)的发生率均高于对照组(9.23%,3.08%),差异具有统计学意义(χ2值分别为6.392和3.900,均P<0.05);在心律失常类型方面比较,观察组窦性心动过速发生率显著高于对照组(χ2=3.900,P=0.048);两组孕妇妊娠结局比较,观察组早产率显著高于对照组(χ2=4.809,P=0.028),两组分娩方式及新生儿体重无显著差异;观察组剖宫产率(χ2=4.775,P=0.029)、早产率(χ2=4.188,P=0.041)及新生儿低体重率(χ2=4.306,P=0.038)均显著高于对照组,差异均具有统计学意义(P<0.05).结论 高龄孕妇妊娠晚期易发生心律失常、ST-T改变等异常心电图改变;异常心电图高龄孕妇的剖宫产、早产及新生儿低体重发生率明显增加,临床上需要关注高龄孕妇妊娠晚期心电图变化,确保母婴安全.

Study on electrocardiogram and pregnancy outcome in older late-stage pregnant women

Objective To explore the abnormal electrocardiogram (ECG) changes and their correlation with pregnancy outcomes in older late-stage pregnant women .Methods Altogether 130 late-stage pregnant women were selected in Hangzhou Xixi Hospital and divided into observation group with 65 cases (aged≥35) and control group with 65 cases (aged <35).The incidence of abnormal ECG and the types of arrhythmia were observed in two groups .The relationship between pregnancy outcomes and abnormal ECG of two groups was analyzed . Results The incidence of abnormal ECG in the observation group ( 32.31%) was significantly higher than that in the control group (15.38%) (χ2 =5.125,P=0.024),and the difference was statistically significant (P<0.05).The incidences of arrhythmia (26.15%) and ST-T changes (12.31%) in the observation group were higher than those in the control group with statistical significance (χ2 value was 6.392 and 3.900, respectively, both P<0.05).The incidence of sinus tachycardia in the observation group was significantly higher than in the control group (χ2 =3.900, P=0.048).Focusing on pregnancy outcomes of women with normal ECG , the preterm birth rate of the observation group was higher than the control group (χ2 =4.809,P=0.028), but there were no significant differences between two groups in delivery mode and neonatal birth weight .The cesarean section rate (χ2 =4.775, P=0.029), preterm birth rate (χ2 =4.188,P=0.041) and low birth weight rate (χ2 =4.306, P=0.038) of the observation group were significant higher than those of the control group with statistical significance (P<0.05).Conclusion Older pregnant women in late pregnancy are more susceptible to have abnormal ECG such as arrhythmia and ST-T changes .The incidence of caesarean section , preterm birth and low birth weight increases significantly in older late-stage pregnant women with abnormal ECG .More attention should be paid to ECG changes of older late-stage pregnant women to ensure the safety of mother and child .