经产妇分娩巨大儿的相关围产因素及妊娠结局

目的:探讨经产妇分娩巨大儿的相关围产因素与妊娠结局的关系。方法:回顾性分析2009年1～12月在北京市海淀妇幼保健院分娩的212例非妊娠期糖尿病且无严重内外科合并症的经产妇巨大儿资料,并与同期分娩的初产妇巨大儿及随机选择的无合并症经产妇正常体重儿进行比较。结果:经产妇巨大儿母亲的孕龄、孕末期体重、宫高、腹围、双顶径、胎儿腹围、剖宫产率、产后出血、异常产程、新生儿窒息率等均高于经产妇正常体重儿组(P<0.05)。与初产妇分娩的巨大儿比较,经产妇巨大儿正规产检比例、择期剖宫产率明显降低;过期妊娠、新生儿窒息率增加(P<0.05)。结论:加强经产妇围生期管理,产前正确预测经产妇巨大儿,选择适当的分娩方式,对预防产后出血,降低母婴并发症至关重要。

Relevant perinatal factors of macrosomia born by multiparous women and pregnancy outcome

Objective:To explore the relationship between relevant perinatal factors of macrosomia born by multiparous women and pregnancy outcome. Methods:The data of macrosomia born by 212 multiparous women without gestational diabetic mellutis(GDM) and severe physical or surgical complications who gave birth to their babies in the hospital from January to December in 2009 were analyzed retrospectively,then they were compared with macrosomia born by primiparous women and normal weight infants born by multiparous women without complications who were selected randomly and gave birth to their babies during the same period. Results:The gestational age,body weight during the third trimester of pregnancy,the height of uterus,abdominal circumference,biparietal diameter,fetal abdominal circumference,cesarean section rate,the incidence of postpartum hemorrhage,the incidence of abnormal stages of labor,the incidence of neonatal asphyxia in macrosomia born by multiparous women group were significantly higher than those in normal weight infants born by multiparous women(P<0.05).Compared with the macrosomia born by primiparous women,the proportion of multiparous women who received regular prenatal examination and selective cesarean section rate decreased significantly;the incidences of prolonged pregnancy and neonatal asphyxia increased significantly(P<0.05). Conclusion:Enhancing perinatal management of multiparous women,predicting macrosomia of multiparous women correctly before delivery,choosing appropriate delivery modes are important for preventing postpartum hemorrhage and reducing maternal-infantile complications.