CAJ | 학술논문

目的：探讨高龄初产对妊娠及分娩发生合并症和并发症及分娩方式的影响。方法选取在北京地坛医院2009年6月至2010年9月分娩的高龄初产妇（≥35岁）442例为观察组进行临床分析研究妊娠合并症和妊娠并发症的发生、分娩方式及妊娠结局，随机选取同期非高龄初产妇（＜35岁）450例为对照组，并进行统计学分析。结果观察组妊娠合并子痫前期、子宫肌瘤、羊水少、巨大儿、臀位、糖尿病和糖耐量受损的比例显著高于对照组（χ2值分别为7．470、35．212、8．811、10．874、4．747、12．844、26．159，均P＜0．05）；对照组合并胎儿窘迫、胎膜早破的发生率显著高于观察组（χ2值分别为4．874、6．689，均P＜0．05）。高龄初产妇的剖宫产率为68．3％，明显高于对照组的33．6％。结论高龄初产妇妊娠合并症和并发症的发生明显高于年轻初产妇，应避免高龄妊娠；对高龄妊娠应加强围产期保健，预防妊娠并发症，合理控制剖宫产手术指征，确保母婴安全与健康。
목적：탐토고령초산대임신급분면발생합병증화병발증급분면방식적영향。방법선취재북경지단의원2009년6월지2010년9월분면적고령초산부（≥35세）442례위관찰조진행림상분석연구임신합병증화임신병발증적발생、분면방식급임신결국，수궤선취동기비고령초산부（＜35세）450례위대조조，병진행통계학분석。결과관찰조임신합병자간전기、자궁기류、양수소、거대인、둔위、당뇨병화당내량수손적비례현저고우대조조（χ2치분별위7．470、35．212、8．811、10．874、4．747、12．844、26．159，균P＜0．05）；대조조합병태인군박、태막조파적발생솔현저고우관찰조（χ2치분별위4．874、6．689，균P＜0．05）。고령초산부적부궁산솔위68．3％，명현고우대조조적33．6％。결론고령초산부임신합병증화병발증적발생명현고우년경초산부，응피면고령임신；대고령임신응가강위산기보건，예방임신병발증，합리공제부궁산수술지정，학보모영안전여건강。
Objective To investigate the influence of elderly primipara on pregnancy outcomes and delivery mode .Methods From June 2009 to September 2010 442 cases of elderly primiparas (≥35 years old ) were selected from Beijing Ditan Hospital in experimental group to analyze the incidence of pregnant complications , delivery mode and pregnant outcomes .At the same period 450 normal primiparas were randomly selected in control group to conduct statistical analysis .Results The proportion of cases complicated with preeclampsia , uterine fibroids, oligohydramnios, fetal macrosomia, breech presentation, gestational diabetes, or impaired glucose tolerance was significantly higher in the experimental group than in the control group (χ2 value was 7.470, 35.212, 8.811, 10.874, 4.747, 12.844 and 26.159, respectively, all P<0.05).In the control group the incidence of fetus distress and premature rupture of membrane was significantly higher (χ2 value was 4.874 and 6.689, respectively, both P<0.05).The cesarean section rate of elderly primiparas (68.3%) was remarkably higher than that of the normal primiparas (33.6%).Conclusion The incidence of pregnant complications among elderly primiparas is obviously higher than that among young primiparas , so elderly pregnancy should be avoided .For elderly pregnancy perinatal care should be strengthened , pregnancy complications should be prevented and the indications of cesarean section should be controlled reasonably to ensure maternal and fetal safety and health .