张埃姆

[摘要] 目的 分析和探讨高龄孕妇妊娠和分娩方式、并发症及围生儿的结局。方法 选取本院2016年1月～2017年1月期间的85例高龄孕产妇（年龄≥35岁）为观察对象，将其作为观察组，并且以同期低于35岁的85例孕产妇为对照组，对比分析两组孕产妇的妊娠及分娩结局、并发症以及围生儿结局。 结果 观察组孕产妇妊娠合并糖尿病8.2%，合并心脏病4.7%，合并子宫肌瘤21.2%，合并高血压34.1%；非高龄孕产妇（对照组）妊娠合并症中，合并糖尿病3.5%，合并心脏病2.4%，合并子宫肌瘤2.4%，合并高血压7.1%，两组比较差异具有统计学意义（P<0.05）；观察组妊娠及分娩并发症均高于对照组，差异有统计学意义（P<0.05）。 结论 高龄孕产妇妊娠和分娩的并发症发生率相对较高，因此临床当中应当着重强化孕产妇的孕产期保健，并依据高龄孕产妇的情况选择适当的分娩方式，以降低高龄孕产妇并发症的发生率，从而改善母婴结局。

[关键词] 高龄孕产妇；妊娠；分娩；临床结局

[中图分类号] R714 [文献标识码] B [文章编号] 1673-9701（2017）19-0060-03

[Abstract] Objective To discuss and explore the pregnancy and delivery mode， complications， and outcome of perinatal infants in women in advanced maternal age. Methods 85 women in advanced maternal age（≥35） treated in our hospital from January 2016 to January 2017 were selected as the observation group， and 85 women younger than 35 delivering in the same period of time were selected as the control group. The outcome of pregnancy and delivery， complications， and outcome of perinatal infants were compared between two groups. Results The incidence rate of GDM was 8.2%， the rate of pregnancy with cardiac disease was 4.7%， the rate of pregnancy with uterine fibroid was 21.2%， and rate of HDCP was 34.1% in observation group. As to the rates of complications of pregnancy in the control group， the rate of GDM was 3.5%， the rate of cardiac disease was 2.4%， the rate of uterine fibroid was 2.4%， and the rate of HDCP was 7.1%， showing significant differences between two groups（P<0.05）. The incidence rates of complications of pregnancy and delivery were also significantly higher in the observation group than those in the control group（P<0.05）. Conclusion The incidence rates of complications of pregnancy and delivery are relatively higher in women in advanced maternal age. Therefore， maternal health care should be emphasized， and proper mode of delivery should be selected based on the condition of pregnant woman， to reduce the incidence rate of complications and thus improve the outcome of both mother and infant.

[Key words] Women in advanced maternal age； Pregnancy； Delivery； Clinical outcome

生活節奏的加快以及社会观念的变化，让很多女性主动或者被动地选择晚婚晚育，因此高龄初产妇的数量也在增加。各种社会因素的综合作用致使女性生育年龄推迟的现象已经较为普遍。医学上认为20～29岁是女性妊娠的最佳年龄，35岁以上初产产妇为高龄产妇。女性随着年龄的增加各种妊娠并发症的危险性也就会增加[1，2]。依据相关报道及调查研究，高龄孕产妇在生理、心理及生殖功能等方面与35岁以下的孕产妇相比，更易出现并发症，胎儿的健康也会受到较大的影响[3-5]。此类孕妇最容易出现产程延长或难产问题。因为这个年龄段的产妇坐骨、耻骨、骼骨和骰骨相互结合部基本已经骨化，形成了一个固定的盆腔，此外，高龄产妇生产也容易导致胎儿滞留宫内引发胎儿窘迫。这些因素均会对产妇及胎儿带来危险。……