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目的探讨77例宫内死胎的相关危险因素。方法回顾性分析2004~2013年清华大学第一附属医院收治的宫内死胎产妇的临床病历资料(病例组),并随机选取同期200例单胎活产分娩产妇病历资料(对照组),采用多因素Logistic回归分析宫内死胎的危险因素。结果单因素结果显示,高龄(>30岁)、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、无规律产检、羊水异常、胎儿发育异常的孕妇更易出现宫内死胎(P<0.05);不同孕次、产次、流产史、妊娠期糖尿病的孕妇宫内死胎的发生率比较差异无统计学意义(P>0.05);不同性别胎儿宫内死胎率比较差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,高龄(>30岁)、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、羊水异常、胎儿发育异常是宫内死胎的独立危险因素(OR分别为1.675、1.956、1.863、1.985、1.677、1.945、1.954,P均<0.05);规律产检是保护因素(OR=0.542,P<0.05)。结论高龄(>30岁)、妊娠期高血压疾病、胎盘早剥、前置胎盘、脐带异常、羊水异常、胎儿发育异常是宫内死胎的独立危险因素,临床应重点关注高危人群,采取针对性措施进行干预。
Objective To explore the related risk factors of 77 cases of stillbirth in uterus. Methods The clinical records (case group) of pregnant women with intrauterine fetal death were retrospectively analyzed from 2004 to 2013 in Tsinghua University First Affiliated Hospital. A total of 200 pregnant women with single live birth were selected randomly during the same period (control group) Logistic regression analysis of risk factors for intrauterine stillbirth. Results The univariate analysis showed that intrauterine fetal death was more likely to occur in pregnant women with advanced age (> 30 years), gestational hypertension, placental abruption, placenta previa, umbilical cord abnormality, irregular pregnancy test, amniotic fluid abnormalities and fetal development abnormalities (P < 0.05). There was no significant difference in the incidence of intrauterine fetal death in pregnant women with different gestational age, parity, abortion history and gestational diabetes mellitus (P> 0.05). There was no significant difference in the intrauterine fetal death rate between different sexes P> 0.05). Multivariate logistic regression analysis showed that elderly (> 30 years old), gestational hypertension, placental abruption, placenta previa, umbilical cord abnormality, amniotic fluid abnormality and fetal dysplasia were independent risk factors for stillbirth in the womb 1.675,1.956,1.863,1.985,1.677,1.945,1.954, P <0.05). The regular birth control was protective factor (OR = 0.542, P <0.05). Conclusion The elderly (> 30 years old), hypertensive disorder of pregnancy, placental abruption, placenta previa, umbilical cord abnormality, amniotic fluid abnormality and fetus developmental abnormalities are independent risk factors of intrauterine fetal death. Measures to intervene.