宁波市高龄孕产妇妊娠结局分析

目的：通过对宁波市高龄孕产妇妊娠结局的分析,进一步了解年龄对妊娠结局的影响,为孕期保健服务提供相关依据。方法：从宁波市2008年的孕期保健监测及出生缺陷监测资料中,分别获取高龄孕妇组与年龄〈35岁孕妇组的相关信息,并对二组资料作统计学分析。结果2008年度宁波市常住人口孕产妇中年龄≥35岁的占5.28%,非常住孕产妇的高龄比例为1.65%,经2χ检验,二组人群差异有统计学意义（χ2=455.83,P〈0.001）;2008年度39 872例本地孕产妇中,自然流产率为1.03%,其中高龄孕产妇的自然流产率为2.69%,年龄〈35岁的孕产妇中有1.09%发生自然流产。二组自然流产率比较,差异有统计学意义（χ2=41.583,P〈0.01）;全市61 311例孕产妇中,发现出生缺陷625例,出生缺陷发生率为101.94/万,其中高龄孕产妇的出生缺陷发生率为344.14/万,〈35岁组孕产妇出生缺陷发生率为91.65/万,经χ2检验二组差异有统计学意义（χ2=151.457,P〈0.001）。高龄组孕产妇前10种出生缺陷,与〈35岁组的同种类出生缺陷比较明显增高,且大多有统计学意义,高龄组染色体异常的顺位排列明显靠前。结论：高龄孕产妇的出生缺陷发生率和自然流产率,明显高于年龄〈35岁的孕产妇,应加强对高龄孕产妇的保健指导和孕期监测。

Pregnancy outcomes for women with advanced maternal age in Ningbo city

Objective To summarize the pregnancy outcomes of women with advanced maternal age,so as to study the relation between older maternal age and pregnancy outcome and provide scientific knowledge for prenatal health care.Methods The relevant information of pregnant women aged 35 or older were analyzed retrospectively from surveillance data of prenatal health care and birth defect in Ningbo city in 2008,while pregnant women who delivered at the same period aged less than 35 years were studied as control.Statistical analysis was reviewed and tested.Results There were 5.28% and 1.65% pregnant women aged 35 or older respectively of Ningbo permanent residents and non-permanent residents in 2008,and the difference was significant（χ2=455.83,P0.001）.A total of 1.03% of the 39 872 local pregnancies resulted in spontaneous abortion,relative risks varying from 2.69 to 1.09 for older versus younger women,and the difference was distinctive（χ2=41.583,P0.01）.Besides,625 cases with birth defect was discovered in 61 311 pregnancies,and the birth-defect incidence was 101.94/10 000.The birth-defect incidence of women with advanced maternal age was distinctively higher than that of women less than 35 years（344.14/10 000 and 91.65/10 000,χ2=151.457,P0.001）.In addition,the rates of the ten common birth defects were mostly distinctively higher in older pregnancies than younger pregnancies,and chromosomal abnormality were more common in older pregnancies.Conclusion Increasing age can increase the risk of birth defect and spontaneous abortion,so prenatal health care and monitoring should be strengthened.