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    不同妊娠间隔对单次剖宫产术后再妊娠产妇母婴不良结局的影响

    Effect of different interpregnancy intervals on adverse maternal and infant outcomes in re-pregnant women after a single caesarean section

      摘要
    • 摘要:
      目的 研究不同妊娠间隔对单次剖宫产术后再妊娠产妇母婴不良结局的影响。
      方法 收集单次剖宫产术后再妊娠产妇999例，根据妊娠间隔长短分为0~17月组、18~35月组、36~59月组、≥60月组。比较各组产妇的一般资料，并分析妊娠间隔对母婴不良结局的影响。
      结果 不同妊娠间隔组单次剖宫产术后再妊娠产妇年龄、产前体质量、受教育程度、孕次等比较差异均有统计学意义(P < 0.05)；身高、常住地、产次等比较差异均无统计学意义(P>0.05)。不同妊娠间隔组妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、前置胎盘、产后出血、新生儿转入NICU发生率差异均有统计学意义(P < 0.05~P < 0.01)，与妊娠间隔18~35月组相比，妊娠间隔≥60月组妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、前置胎盘、产后出血发生率上升，0~17月组新生儿转入NICU率升高，差异均有统计学意义(P < 0.05~P < 0.01)。经校正混杂因素后，与18~35月组相比，≥60月组妊娠期高血压疾病、妊娠期糖尿病、胎膜早破、前置胎盘及低出生体质量儿的发生风险升高；0~17月组和≥60月组妊娠期贫血、产后出血发生风险均增加；36~59月组和≥60月组早产的发生风险增加；0~17月组新生儿重症监护病房入住率增加(P < 0.05~P < 0.01)。
      结论 过长或过短的妊娠间隔均会增加母婴不良结局的发生率, 单次剖宫产术后18~35个月再次妊娠的产妇有相对理想的妊娠结局。

       

      Abstract:
      Objective To investigate the effects of different interpregnancy intervals on adverse maternal and infant outcomes in re-pregnant women after a single caesarean section.
      Methods A total of 999 cases of women who were re-pregnant after a single caesarean section were collected and divided into the 0-17 months, 18-35 months, 36-59 months, and ≥60 months groups according to the length of interpregnancy interval.The general data of the mothers in each group were compared, and the effect of interpregnancy interval on the adverse outcomes of mothers and infants was analyzed.
      Results The comparative differences in the age, prenatal body mass, education level, and pregnancy time of women who became pregnant after a single cesarean section in different interpregnancy interval groups were all statistically significant (P < 0.05).The comparative differences in height, permanent residence, and birth were not statistically significant (P>0.05).The differences in the incidence of hypertensive disorders of pregnancy, gestational diabetes mellitus, premature rupture of membranes, placenta praevia, postpartum haemorrhage, and neonatal transfer to the NICU in the different interpregnancy interval groups were statistically significant (P < 0.05 to P < 0.01).Compared with the 18-35 months group, the incidence of hypertensive disorders of pregnancy, gestational diabetes mellitus, premature rupture of membranes, placenta praevia, and postpartum haemorrhage increased in the ≥60 months group, and the rate of neonatal transfer to the NICU increased in the 0-17 months group, and all the differences were statistically significant (P < 0.05 to P < 0.01).After correcting for confounders, the risk of hypertensive disorders of pregnancy, gestational diabetes mellitus, premature rupture of membranes, placenta praevia, and low-birth-body mass babies was elevated in the ≥60 months group compared with the 18-35 months group; the risk of anaemia in pregnancy and post-partum haemorrhage was increased in both the 0-17 months group and ≥60 month groups the risk of preterm birth was increased in the 36-59 months group and ≥60 month group; and the increased NICU admissions in the 0-17 months group (P < 0.05~P < 0.01).
      Conclusions Excessively long or short interpregnancy intervals increase the incidence of adverse maternal and infant outcomes, and women who have a second pregnancy 18-35 months after a single cesarean section have relatively favorable pregnancy outcomes.

       

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