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目的探讨孕妇乙肝表面抗原阳性对早产的发生是否有影响。方法回顾性分析2009年5月~2011年7月期间188例HBsAg阳性孕妇的妊娠期并发症、危险因素及妊娠结局,系统抽取同期病案号末位数是1和9的HBsAg阴性孕妇265例作为对照组。结果孕妇HBsAg阳性胎盘前置发生率明显高于HBsAg阴性孕妇(2.66%vs 0%,P=0.03);阳性组<37周的早产发生率明显高于阴性组(12.23%vs 6.04%,P=0.02)。两组之间妊娠高血压、子痫前期、妊娠期糖尿病、糖耐量异常、胎膜早破、剖宫产和产后出血的发生率无统计学差异(P>0.05)。两组之间新生儿体质量、身长、头围、Apgar评分等婴儿发育指标也无显著差异(P>0.05)。Logistic回归分析显示,孕妇HBsAg阳性、ALT升高、胎盘前置以及重度子痫前期是早产的危险因素。结论 HBsAg阳性孕妇可增加早产的风险,但它并不影响胎儿宫内生长。
Objective To investigate whether the positive HBsAg in pregnant women has any effect on the occurrence of premature labor. Methods The pregnancy complications, risk factors and pregnancy outcomes of 188 HBsAg positive pregnant women from May 2009 to July 2011 were analyzed retrospectively. A total of 265 HBsAg negative pregnant women with 1 and 9 medical records at the same period Control group. Results The incidence of HBsAg positive placenta previa in pregnant women was significantly higher than that in HBsAg negative pregnant women (2.66% vs 0%, P = 0.03). The incidence of preterm birth was significantly higher in the positive group than in the negative group at 37 weeks (12.23% vs 6.04%, P = 0.02). The incidence of pregnancy-induced hypertension, preeclampsia, gestational diabetes mellitus, impaired glucose tolerance, premature rupture of membranes, cesarean section and postpartum hemorrhage were not significantly different between the two groups (P> 0.05). Neonatal body weight, length, head circumference, Apgar score and other indicators of infant development between the two groups also showed no significant difference (P> 0.05). Logistic regression analysis showed that pregnant women HBsAg positive, elevated ALT, placenta previa and severe preeclampsia are risk factors for preterm birth. Conclusion HBsAg-positive pregnant women may increase the risk of preterm birth, but it does not affect fetal intrauterine growth.