Mikulandra F, Merlak I, Perisa M, Sikić D, Jerković J
Sluzba za zastitu zdravlja zena Medicinski centar u Sibeniku.
Jugosl Ginekol Perinatol. 1991 Jan-Apr;31(1-2):11-5.
During the 1970-1989 period, there were 23,915 deliveries of which 278 (1.16%) occurred in women 40 years of age or older. The latter included 62 (22.3%) primiparas, 158 (56.8%) pluriparas and 58 (20.9%) multiparas. The control group consisted of 14,400 women 20-34 years of age (50% primiparas and 50% pluriparas) from the same period. There was no antenatal visit in 9.4% of the women 40 years of age or older. This group included more housewives, more unmarried women and more women with previous spontaneous and induced abortions than the control group (P less than 0.05). Threatened abortion (16.2%), EPH gestosis (22.3%), impaired glucose tolerance (8.3%), gestational diabetes (7.2%), delivery before 37 weeks (11.5%), delivery after 42 weeks (3.6%), premature rupture of the membranes (18.3%), meconium-stained amniotic fluid (19.8%), elective caesarean section (11.5%), caesarean section delivery (16.5%), vacuum extraction (4.7%), placental lysis or uterine exploration (4.3%) were more frequent in the study than in the control group (P less than 0.05). There were more cases with episiotomy (P less than 0.001) in the control group, whereas there were no differences as regards cervical cerclage, weight gain above 14kg, breech presentation, transverse presentation and assisted breech delivery between the two groups (P greater than 0.05). There was no case of uterine rupture or maternal death either in the study or the control group. The authors conclude that a woman 40 years of age and older is in an advanced age for pregnancy and delivery.(ABSTRACT TRUNCATED AT 250 WORDS)
在1970年至1989年期间,共有23915例分娩,其中278例(1.16%)发生在40岁及以上的女性中。后者包括62例(22.3%)初产妇、158例(56.8%)经产妇和58例(20.9%)多产妇。对照组由同期14400名20至34岁的女性组成(50%为初产妇,50%为经产妇)。40岁及以上的女性中有9.4%未进行产前检查。与对照组相比,该组家庭主妇更多、未婚女性更多,且既往有自然流产和人工流产史的女性更多(P<0.05)。研究组中先兆流产(16.2%)、妊娠高血压综合征(22.3%)、糖耐量受损(8.3%)、妊娠期糖尿病(7.2%)、37周前分娩(11.5%)、42周后分娩(3.6%)、胎膜早破(18.3%)、羊水粪染(19.8%)、选择性剖宫产(11.5%)、剖宫产分娩(16.5%)、真空吸引(4.7%)、胎盘剥离或子宫探查(4.3%)的发生率高于对照组(P<0.05)。对照组会阴切开术的病例更多(P<0.001),而两组在宫颈环扎、体重增加超过14kg、臀位、横位和臀位助产方面无差异(P>0.05)。研究组和对照组均未发生子宫破裂或孕产妇死亡病例。作者得出结论,40岁及以上的女性怀孕和分娩属于高龄。(摘要截选至250词)