影响子痫前期围产儿结局的多因素分析

目的 探讨影响子痫前期围产儿结局的因素.方法 采用单因素和多因素Logistic回归对448例子痫前期患者的围产儿结局进行分析.结果 448例子痫前期发生围产儿不良结局者共94例(21.0%),其中围产儿死亡41例(9.2%).对孕妇的58项变量行单因素分析显示,影响围产儿结局的因素有:发病孕周、分娩孕周、自觉症状、抽搐、尿蛋白、水肿、收缩压、舒张压、白细胞计数、中性粒细胞计数、24 h尿蛋白定量、血浆白蛋白、乳酸脱氢酶(LDH)、肌酐、产检次数、血压升高孕周和水肿孕周等17项变量(P＜0.05);Logistic逐步回归筛选出的多因素依次为:分娩孕周(OR 0.583, 95%CI:0.367～0.926),自觉症状(OR 9.315,95%CI:1.500～57.833)和尿蛋白(OR 3.394,95%CI:1.226～9.397).结论 加强围产期保健,延长分娩孕周,可以减少子痫前期患者围产儿不良结局的发生.

Multivariate Analysis of Impacting Perinatal Outcomes in Preeclampsia

Objective To discuss the influencing factors of perinatal outcomes in preeclampsia. Methods Statistically the single factor analysis and multivariate logistic regression analysis were performed for 448 preeclamptic women. Results There were 94 cases (21.0%) with bad perinatal outcomes in 448 preeclamptic women, among which there were 41 perinatal death cases (9.2%). Single analyses showed that onset gestation weeks, labor gestation weeks, subjective symptoms, convulsion, proteinuria degrees, edema, systolic pressure, diastolic pressure, white blood count, granulocyte count, urine protein quantity, plasma-albumin, lactate dehydrogenase, creatinine, antenatal care frequencies, hypertension (gestation weeks) and edema (gestation weeks) were correlated to bad perinatal outcomes (P<0.05). The logistic regression screened out such factors as labor gestation weeks (OR 0.583, 95%CI: 0.367-0.926), subjective symptoms (OR 9.315,95%CI: 1.500-57.833) and proteinuria degrees(OR 3.394, 95%CI: 1.226-9.397), which would influence perinatal outcome in preeclampsia. Conclusion Regular antenatal cares and extending gestation weeks may improve the perinatal outcome in preeclampsia.