78例死胎高危因素临床分析

目的:探讨死胎发生的高危因素。方法:将2007年1月～2010年11月苏州大学附属第一人民医院住院分娩的死胎78例设为病例组,随机抽取同期住院分娩活产156例作为对照组,对两组18个社会及临床因素进行回顾性分析。结果:比较两组的高龄、职业、教育程度、产前检查、孕周、出生体重、胎数、产次、胎膜早破、胎盘早剥、胎儿畸形、母体合并症等指标,差异有统计学意义。Logistic回归分析表明无正规产前检查(OR=3.202,95%CI 3.074～3.548)、低出生体重(OR=0.998,95%CI 0.997～0.999)、无业(OR=1.279,95%CI 1.096～1.804)、胎儿畸形(OR=2.264,95%CI 2.102～2.573)、母体疾病(OR=4.608,95%CI 10.859～24.707)是发生死胎的高危因素。结论:必须加强产前检查,提高产前诊断水平,及时发现早期胎儿畸形,加强对高危孕妇的筛选及重点监护,积极治疗各种妊娠合并症及并发症,减少死胎的发生。

Clinical analysis on high risk factor of 78 cases with stillbirth

Objective:To explore the high risk factors of stillbirth.Methods:A total of 78 cases with stillbirth who were born in the hospital from January 2007 to November 2010 were selected as case group,and 156 live births who were born during the same period were randomly selected as control group,18 social and clinical factors were analyzed retrospectively in the two groups.Results:There were statistically significant difference in age,occupation,education level,prenatal examination,gestational weeks,birth weight,parity,premature rupture of membrane(PROM),placental abruption,fetal malformation,and maternal complications between the two groups.Logistic regression analysis showed that the high risk factors of stillbirth included regular prenatal examination(OR=3.202,95%CI: 3.074-3.548),low birth weight(OR=0.998,95%CI: 0.997-0.999),unemployed(OR=1.279,95%CI: 1.096-1.804),fetal malformation(OR=2.264,95%CI: 2.102-2.573),and maternal diseases(OR=4.608,95%CI: 10.859-24.707).Conclusion:To reduce the occurrence of stillbirth,the necessary measures include enhancing prenatal examination,improving prenatal diagnostic level,finding fetal malformation early and timely,strengthening screening and monitoring of high risk pregnant women,and curing pregnant complications actively.