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[既往人工流产、自然流产和死产对低体重儿和早产儿发生率的影响以及新生儿的躯体分类]

[The influence of previous pregnancy terminations, miscarriages and still-births on the incidence of babies with low birth weight and premature births as well as a somatic classification of newborns].

作者信息

Voigt M, Olbertz D, Fusch C, Krafczyk D, Briese V, Schneider K T M

机构信息

Abt. Neonatologie und Pädiatrische Intensivmedizin am Zentrum für Kinder- und Jugendmedizin der Ernst-Moritz-Arndt Universität Greifswald.

出版信息

Z Geburtshilfe Neonatol. 2008 Feb;212(1):5-12. doi: 10.1055/s-2008-1004690.

Abstract

AIM

The influence of previous interruptions, miscarriages and IUFD on the IUGR and preterm rate as well as on the somatic staging (gestational age and birth weight) of the new born is a subject of controversial discussion in the literature. The present paper attempts to quantify these risks of the medical history. 2 282 412 singleton pregnancies of the period 1995 to 2000 were evaluated from the German Perinatal Database. For the analysis 1 065 202 pregnancies (46.7 %) of those mothers without any live birth in the medical history were assessed. To exclude any influence from previous abortions patients with previous miscarriages and IUFDs were excluded. The control collective were new borns whose mothers had suffered neither from miscarriages nor from abortions or IUFD.

RESULTS

Previous interruptions, miscarriages and IUFD influence the rate of new borns with low birth weight and increase the rate of prematurity. With increasing numbers of isolated or combined risks in the medical history, the rate of newborns with a low birth weight or with prematurity is increased. The lowest risk was found after one interruption, the highest rate with two or more IUFDs. Interruptions, miscarriages or IUFD are not risk factors for IUGR or SGA.

CONCLUSION

Previous interruptions, miscarriages and IUFD are relevant risk factors for prematurity and are related with low birth weight of the new borns. Pregnant women with such risk factors have to been considered as risk pregnancies and need intensive surveillance.

摘要

目的

既往流产、死产及胎儿宫内死亡对胎儿生长受限和早产率以及新生儿体格分期(孕周和出生体重)的影响在文献中是一个有争议的讨论话题。本文试图量化这些病史风险。对德国围产期数据库中1995年至2000年期间的2282412例单胎妊娠进行了评估。分析时评估了其中1065202例(46.7%)病史中无活产的母亲的妊娠情况。为排除既往流产的任何影响,排除了有既往流产和胎儿宫内死亡的患者。对照组为其母亲既未流产、堕胎也未发生胎儿宫内死亡的新生儿。

结果

既往流产、死产及胎儿宫内死亡影响低出生体重新生儿的发生率并增加早产率。随着病史中孤立或合并风险数量的增加,低出生体重或早产新生儿的发生率增加。一次流产后风险最低,两次或更多次胎儿宫内死亡时发生率最高。流产、死产或胎儿宫内死亡不是胎儿生长受限或小于胎龄儿的风险因素。

结论

既往流产、死产及胎儿宫内死亡是早产的相关风险因素,且与新生儿低出生体重有关。有此类风险因素的孕妇应被视为高危妊娠,需要加强监测。

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