许海燕，徐道珍

(伊宁市农四师医院，新疆 伊宁 835000)



高龄孕妇妊娠晚期异常心电图对妊娠结局的影响

许海燕，徐道珍

(伊宁市农四师医院，新疆 伊宁 835000)

目的探讨高龄孕妇妊娠晚期异常心电图(ECG)的变化与妊娠结局之间的关系及对妊娠结局的影响。方法随机选取360例于2013年5月至2015年5月在伊宁市农四师医院就诊的妊娠晚期(28～41孕周)孕妇，按年龄将35岁以上的患者分为高龄孕妇组，35岁及以下者为适龄孕妇组，对所有患者进行ECG常规检查，并统计两组患者的妊娠结局，分析高龄孕妇组妊娠晚期的异常ECG变化及其对妊娠结局的影响。结果高龄孕妇组异常ECG发生率为31.1%，显著高于适龄组的21.1%，两组差异具有统计学意义(χ2=4.53，P<0.05)。高龄组ECG异常主要表现为ST段的改变、心率失常、短P-R间期、电轴左偏、低电压，其各项的发生率均显著高于适龄组，两组差异均具有统计学意义(χ2值分别为5.68、7.21、6.52、5.63、6.23，均P<0.05)。在ECG正常孕妇中适龄孕妇组和高龄孕妇组的妊娠结局及新生儿出生体重无明显差异(均P>0.05)，但高龄孕妇组早产儿发生率显著高于适龄孕妇组(χ2=4.98，P<0.05)。在异常ECG孕妇中，适龄孕妇组的流产死胎率、早产率、新生儿低出生体重率均显著低于高龄孕妇组，差异均具有统计学意义(χ2值分别为5.67、12.79、7.93，均P<0.05)。结论高龄孕妇在妊娠晚期异常ECG发生率较高，其流产、早产、新生儿低出生体重率也相对较高，临床上应给予关注。

高龄孕妇；妊娠晚期；异常心电图；妊娠结局

[Abstract]Objective To explore the relationship between the changes of abnormal electrocardiogram (ECG) of older late-stage pregnant women and the pregnancy outcomes and to identify the effect of abnormal ECG on pregnancy outcomes. Methods A total of 360 pregnant women had been selected randomly from those who were in late-stage pregnancy (28-41 gestational weeks) and diagnosed in the Fourth Agriculture Division Hospital of Yining from May 2013 to May 2015. Based on age, subjects over the age of 35 were put in older pregnant women group, and pregnant women who were 35 and younger were served in pregnancy-age women group. ECG was performed as a routine test for all subjects, and pregnancy outcomes were recorded so as to analyze the abnormal changes of ECG and their influence on pregnancy outcomes. Results Among the older pregnant women group, the incidence of abnormal ECG was 31.1%, which was higher than that (21.1%) of the pregnancy-age women group with statistical significance (χ2=4.53,P<0.05). The major manifestation of abnormal ECG of older pregnant women group were ST segment changes, arrhythmia, short period between P-R, left axis deviation and low voltage, and the incidence of them was higher than that of pregnancy-age women group. The differences between two groups were significant (χ2value was 5.68, 7.21, 6.52, 5.63 and 6.23, respectively, allP<0.05). However, pregnancy-age women with normal ECG showed no difference in pregnancy outcomes and newborn birth weight between older pregnant women group and pregnancy-age women group (allP>0.05), but the occurrence of premature infants in older pregnant women group was evidently higher than that in pregnancy-age women group (χ2=4.98,P<0.05). In pregnant women with abnormal ECG, the abortion stillbirth rate, premature birth rate and low birth weight in neonates rate were significantly lower than those of older pregnant women group, and the differences were statistically significant (χ2value was 5.67, 12.79 and 7.93，respectively, allP<0.05). Conclusion The occurrence of abnormal ECG is relatively higher in older late-stage pregnant women, and the incidences of abortion, premature birth and low birth weight in neonates are relatively high, which needs to be concerned in clinics.

[Key words]older pregnant women; late pregnancy; abnormal electrocardiogram; pregnancy outcomes

妇女在妊娠后身体会发生一系列的生理性变化，如代谢增强，心脏代偿能力的减弱，同时体内激素水平及物质循环的变化等。正常的适龄孕妇一般都能代偿机体的变化，但对于高龄孕妇，随着孕周的增加，机体变化愈加明显，除物质代谢异常、血流量及血流动力学发生改变外，高龄孕妇的心脏功能及其电激反应也都会发生一系列变化，在产前常规检查时会出现心电图(ECG)异常现象[1]。在以往的研究中主要研究的是孕产妇异常ECG的类型及发生频率等，关于高龄孕妇的异常ECG及其妊娠结局的研究较少[2]。在临床中主要目的还是孕妇及新生儿的健康，故在本……