欧阳彦兰 曾喜群 黄燕婷 温慧君

[摘要]目的分析妊娠合并子宮肌瘤孕妇先兆流产发生的危险因素，为减少妊娠合并子宫肌瘤孕妇先兆流产的发生提供依据。方法采用简单随机抽样的方法选择2018年1月至2021年2月广东省惠州市第一妇幼保健院收治的60例妊娠合并子宫肌瘤孕妇，根据是否发生先兆流产分为先兆流产组（ n=18）和无先兆流产组（ n=42）。详细收集孕妇临床资料，通过单因素和多因素 logistic 回归分析法分析妊娠合并子宫肌瘤孕妇先兆流产发生的相关影响因素。结果单因素分析结果显示，子宫肌瘤直径、子宫肌瘤数目、子宫肌瘤类型、既往流产史以及孕次是影响妊娠合并子宫肌瘤孕妇先兆流产发生的重要因素（ P <0.05）;居住地类型、年龄、学历水平、子宫肌瘤部位、是否在职、产次、孕前吸烟以及孕前饮酒与妊娠合并子宫肌瘤孕妇先兆流产的发生无相关（ P >0.05）。多因素 logistic 回归分析显示，子宫肌瘤直径、子宫肌瘤数目、子宫肌瘤类型、既往流产史是妊娠合并子宫肌瘤孕妇先兆流产发生的主要独立危险因素（ P <0.05）。结论子宫肌瘤直径、子宫肌瘤数目、子宫肌瘤类型、既往流产史是影响妊娠合并子宫肌瘤孕妇先兆流产发生的主要危险因素，临床上应加强对妊娠合并子宫肌瘤孕妇的检查评估，制订针对性的治疗干预措施，以降低孕妇先兆流产等并发症发生风险，确保孕妇顺利分娩。

[关键词]妊娠;子宫肌瘤;孕妇;先兆流产;危险因素;多因素logistic 回归分析

[中图分类号] R737.33; R714.2 [文献标识码] A  [文章编号]2095-0616（2021）22-0145-04

Risk factors for the occurrence of early threatened abortion in pregnant women with uterine fibroids

OUYANG  Yanlan   ZENG  Xiqun   HUANG  Yanting   WEN  Huijun

Department of Gynecology， Huizhou No.1 Maternal and Child Care Service Center， Guangdong， Huizhou 516000，China

[Abstract] Objective To analyze the risk factors for the occurrence of early threatened abortion （ETA） in pregnant women with uterine fibroids， and provide a basis for reducing the occurrence of ETA in pregnant women with uterine fibroids. Methods A total of 60 cases of pregnant women with uterine fibroids admitted to the Huizhou No.1 Maternal and Child Care Service Center in Guangdong province from January 2018 to February 2021 were selected by the simple random sampling method， and divided into the ETA group （n=18） and the non-ETA group （n=42） according to the occurrence of ETA. The clinical data of pregnant women were collected in detail， and the factors influencing the occurrence of ETA in pregnant women with uterine fibroids were analyzed by univariate and multivariate logistic regression analysis. Results The results of univariate analysis showed that the diameter of fibroids， number of fibroids， type of fibroids， history of previous abortion and times of pregnancy were significant factors influencing the occurrence of ETA in pregnant women with uterine fibroids （P <0.05）. The results also showed that the type of residence， age， education level， location of fibroids， occupation status， parity， pre-pregnancy smoking and pre-pregnancy alcohol consumption were not significantly related to the occurrence of ETA in pregnant women with uterine fibroids （P >0.05）. Multivariate logistic regression analysis showed that the diameter of fibroids， number of fibroids， type of fibroids and history of previous abortion were the main independent risk factors for the occurrence of ETA in pregnant women with uterine fibroids （P <0.05）. Conclusion The diameter of fibroids， number of fibroids， type of fibroids and history of previous abortion are the main risk factors for the occurrence of ETA in pregnant women with uterine fibroids. Clinical examination and evaluation of pregnant women with uterine fibroids should be strengthened， and targeted therapeutic interventions should be developed to reduce the risks of complications such as ETA and ensure smooth delivery.

[Key words] Pregnancy; Uterine fibroids; Pregnant women; Early threatened abortion; Risk factors; Multivariate logistic regression analysis

子宫肌瘤是女性常见良性生殖系统肿瘤，近年来，随着高龄产妇增多以及我国生育政策改变，妊娠合并子宫肌瘤孕妇越来越多[1]。先兆流产指的是女性在妊娠期20周之前发生的流产现象，是妊娠期常见并发症，由于先兆流产的发生机制复杂，因此预测和治疗先兆流产对临床医师来说是一个挑战[2]。有研究指出，在妊娠早期时子宫肌瘤对受精卵着床以及生长发育有一定影响，增加了流产风险;在妊娠中晚期时会影响胎儿宫内活动情况，增加了横位及臀位几率[3-4]。……