236例巨大儿临床特征及妊娠结局分析

目的:探讨非糖尿病巨大儿的危险因素、分娩方式及其妊娠结局。方法:通过对某医院非糖尿病孕妇分娩巨大儿236例与随机选取同期分娩正常儿的孕妇225例作对照回顾性分析。以产前B超或临床估计胎儿体重≥4.0kg为标准,将研究组再分为临床预测组(A组)108例和非预测组(B组)128例,对其分娩方式及母儿并发症进行比较。结果:研究组在平均孕龄、孕末期体重、剖宫产率、产后出血均高于对照组(P0.01);两组在孕妇身高、胎儿窘迫、新生儿窒息方面无显著差异(P0.05)。A组总剖宫产率及选择性剖宫产率高于B组(P0.01);产道损伤及新生儿产伤发生率低于B组,但无显著差异(P0.05)。结论:孕龄、孕末期体重及胎儿性别是巨大儿的主要危险因素。积极预防巨大儿发生,加强产前预测,选择合适的分娩方式,是降低围生期并发症重要方法之一。

Analysis of clinical characteristics and pregnancy outcome of macrosomia

Objective：To investigate risk factors, mode of delivery and pregnancy outcome of non-diabetic macrosomia.Methods：236 cases of non-diabetic macrosomia were matched with 225 cases of normal-birth-weight new-born selected at random for the retrospective case-control study. Otherwise, the case were divided into predicted group and unpredicted group, according to whether clinical or ultrasonographic prediction of birth weight was more than 4.0kg. Results： Gestationalage and telophasic body of pregnancy and they cesarean delivery rate and postpartum hemorrhage in the study group were greater than that in the control group （P〈0.01）. body height and fetal distress and asphyxia of newborn were no significant difference between two groups （P〉0.05）.Either total or selective cesarean de- livery rate was greater in the predicted group than that in the unpredicted group. Injury of parturient canal and birth Injury were lower in the predicted group than that in the unpredicted group, but no significant （P〉0.05）. Conclusion： The risk factors were Gestationalage and telophasic body of pregnancy and fetus-sex. Macrosomia was relevant of perinatal morbidity rate. The active prevention of macrosmia and the antenatal prediction of macrosomia and suitable mode of delivery were one of the most important measures for lowering the perinatal morbidity.