孕期负性生活事件与妊娠结局的关系

目的了解孕期负性生活事件发生情况,并探讨其对妊娠结局的影响。方法选取2012年4月1日至2013年3月31日在北京、广东、湖南、湖北、四川和陕西六省市15家医疗保健机构分娩的9137例孕28周及以上的活产产妇[(28. 76±6. 53)岁]作为研究对象,使用自制调查问卷收集其基本情况、孕期负性事件发生情况、孕期合并症/并发症和妊娠结局等信息,采用二分类Logistic回归模型分析孕期负性生活事件对妊娠结局的影响,以及不良妊娠结局的影响因素。结果 1395例(15. 3%)产妇在孕期经历负性生活事件,5439例(59. 5%)产妇发生了不良妊娠结局。控制混杂因素后,孕期经历负性生活事件的产妇早产的发生风险是未经历者的1. 257倍(95%CI 1. 051~1. 504),娩出低出生体重儿的风险为1. 316倍(95%CI1. 055~1. 643)。多因素Logistic回归分析结果显示,孕期发生负性生活事件(OR=1. 201,95%CI 1. 056~1. 365)、妊娠期高血压综合征(OR=2. 278,95%CI 1. 867~2. 781)、孕前超重或肥胖(OR=1. 299,95%CI 1. 140~1. 480)、高龄(OR=1. 197,95%CI 1. 014~1. 413)为不良妊娠结局的危险因素,初产(OR=0. 808,95%CI 0. 715~0. 913)为不良妊娠结局的保护因素。在不同类型孕期负性生活事件中,控制混杂因素后,家庭不和睦者发生不良妊娠结局的风险是未出现家庭不和睦者的1. 259倍(95%CI 1. 076~1. 473)。结论被调查产妇孕期负性生活事件发生率较高,孕期经历负性生活事件能够显著增加不良妊娠结局的发生风险。

Relationship between prenatal negative life events and pregnancy outcomes

OBJECTIVE To assess the prevalence of prenatal negative life events,and explore the effect of prenatal negative life events on pregnancy outcomes.METHODS A total of 9137 postpartum women( average age: 28. 76±6. 53 years) who delivered live neonates with gestational age ≥28 weeks between April,2012 to March,2013 in 15 hospitals in Beijing,Guangdong,Hunan,Hubei,Sichuan and Shaanxi provinces were enrolled. Self-made questionnaire was used to collect general information,occurrence of negative life events during pregnancy,complications during pregnancy and pregnancy outcomes. Logistic regression models were used to analyze the effect of prenatal negative life events on adverse pregnancy outcomes and influencing factors of adverse pregnancy outcomes. RESULTS In total of 1395 women( 15. 3%) had experienced prenatal negative life events, and 5439 women( 59. 5%) had adverse pregnancy outcomes. After adjusting for covariates,women who experienced prenatal negative life events had an increased risk of preterm birth( OR = 1. 257,95% CI 1. 051-1. 504),and delivering low birth weight infants( OR = 1. 316,95% CI 1. 055-1. 643). Multivariate Logistic regression models showed that prenatal negative life events( OR = 1. 201,95% CI1. 056-1. 365),pregnancy-induced hypertension( OR = 2. 278,95% CI 1. 867-2. 781),pre-pregnancy overweight or obese( OR = 1. 299,95% CI 1. 140-1. 480) and delivery age above 35 years old( OR = 1. 197,95% CI 1. 014-1. 413) were risk factors for adverse pregnancy outcomes;and primiparity( OR = 0. 808,95% CI 0. 715-0. 913) were protective factors for adverse pregnancy outcomes. Among different types of negative life events,women with family disharmony had increased risk of adverse pregnancy outcomes than those without family disharmony after adjusting for covariates( OR = 1. 259,95% CI1. 076-1. 473). CONCLUSION In this study,prenatal negative life events were prevalent,and prenatal negative life events may increase the risk of pregnancy outcomes.