高级检索

    基于倾向性评分匹配法探索经阴道分娩的新生儿体质量与产后出血的关系

    Study on the relationship between neonatal body weight and postpartum hemorrhage in vaginal delivery based on propensity score matching

      摘要
    • 摘要:
      目的 基于倾向性评分匹配法探讨经阴道分娩的新生儿体质量与产后出血的关系。
      方法 选择经阴道分娩的10 046例产妇为研究对象，根据新生儿体质量分为非巨大儿组(新生儿体质量<4 000 g)和巨大儿组(新生儿体质量≥4 000 g)，对2组行1∶1倾向性评分匹配，采用logistic回归分析新生儿体质量与产后出血的关系，并根据logistic回归分析结果对新生儿体质量与产后出血的关系进行分层分析。
      结果 共751对产妇完成倾向性评分匹配，匹配后2组一般特征基本平衡。匹配后的1 502例产妇，197例出现产后出血，产后出血率为13.1%。匹配后产后出血和未发生产后出血产妇中孕次、产次、产前发热、巨大儿、高血压、胎盘娩出方式比较，差异均有统计学意义(P<0.05~P<0.01)。logistic回归分析结果显示，巨大儿产后出血的风险是非巨大儿的1.994倍(95%CI: 1.448~2.746，P<0.01)。新生儿体质量的4个百分位数P5、P25、P75、P95分别为2 035.8、2 600.0、4 130.0、4 398.5 g。根据P25、4 000 g、P75将新生儿体质量分为4组，调整可能的混杂因素后，新生儿体质量4 000~<4 130 g组和新生儿体质量≥4 130 g组产后出血的风险是新生儿体质量<2 600 g组的9.047倍和11.235倍。
      结论 新生儿体质量是产后出血的重要影响因素，随着新生儿体质量的升高发生产后出血的危险性升高。

       

      Abstract:
      Objective To explore the relationship between neonatal body weight and postpartum hemorrhage in vaginal delivery based on propensity score matching.
      Methods A total of 10 046 women who delivered vaginally were selected as the study subjects, and divided into the non-macrosomia group (neonatal body weight<4 000 g) and macrosomia group (neonatal body weight ≥4 000 g) according to neonatal body weight. The 1∶1 propensity score in two groups was matched, the relationship between neonatal body weight and postpartum hemorrhage was analyzed by logistic regression, and the relationship between neonatal body weight and postpartum hemorrhage was further stratified according to the results of logistic regression analysis.
      Results A total of 751 pairs of women were matched with propensity scores, and the general characteristics of the two groups were basically balanced. The incidence of postpartum hemorrhage was 197(13.1%) among the 1 502 women who were matched. The differences of the pregnancy, parity, prenatal fever, macrosomia, hypertension, and placental delivery mode between the general characteristics of postpartum hemorrhage and non-postpartum hemorrhage after matching were statistically significant(P<0.05 to P<0.01). The results of logistic regression analysis showed that the risk of postpartum hemorrhage in macrosomia was 1.994 times higher than that in nonmacrosomia infants(OR=1.994, 95%CI: 1.448-2.746, P<0.01)。The four percentiles of neonatal body weight (P5, P25, P75, P95) were 2 035.8 g, 2 600.0 g, 4 130.0 g, 4 398.5 g, respectively. According to the three values of P25, 4 000 g and P75, the neonatal body weight was divided into four groups, and after adjusting for possible confounding factors, the risk of postpartum hemorrhage in the neonatal body weight 4 000-<4 130 g group and neonatal body weight ≥4130 g group were 9.047 times and 11.235 times higher than that in neonatal body weight<2 600 g group.
      Conclusions Neonatal body weight is an important influencing factor of postpartum hemorrhage, and the risk of postpartum hemorrhage increases with the increase of neonatal body weight.

       

      • HTML全文
      • 参考文献(16)
      • 相关文章
      • 施引文献
    • 资源附件(0)

    /

    返回文章
    返回