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[子痫前期胎盘早剥危险因素的多因素分析]

[Multivariate analysis of risk factors with placental abruption in preeclampsia].

作者信息

Wang Ya-nan, Yang Zi

机构信息

Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing 100191, China.

出版信息

Zhonghua Fu Chan Ke Za Zhi. 2010 Nov;45(11):825-8.

PMID:21211280
Abstract

OBJECTIVE

To investigate the risk factors with placental abruption in patients with preeclampsia.

METHODS

Retrospective analysis on medical documents of 219 patients treated in Peking University Third Hospital from Jan. 1994 to Dec. 2008. Patients were divided into 3 groups, including 52 cases with severe preeclampsia terminated following placental abruption, 130 cases only with severe preeclampsia and 37 cases with unexplained placental abruption without preeclampsia. One hundred and seventy-eight normal pregnancies were selected as the control group (1:2 case-control). Univariate and multivariate regression analysis were used to identify the risk factors for placental abruption in patients with preeclampsia.

RESULTS

(1) When compared with those in control group, univariate analysis showed that gravidity, parity, history of preeclampsia, second and third trimester pregnancy loss, history of autoimmune disease, chronic hypertension disease, lack of regular antenatal care, fetal growth restriction (FGR) and raises of umbilical artery Doppler resistance were risk factors associated with placental abruption. Logistic regression analysis showed that lack of a regular antenatal care (OR = 45.348, 95%CI: 17.096 - 120.288, P = 0.000), FGR (OR = 27.087, 95%CI: 5.585 - 131.363, P = 0.000) and second/third trimester pregnancy loss (OR = 16.068, 95%CI: 1.698 - 152.029, P = 0.015) were independent risk factors with placental abruption. (2) When compared with those in preeclampsia patients without placental abruption, the history of preeclampsia (OR = 3.715, 95%CI: 1.096 - 12.596, P = 0.035) and lack of a regular antenatal care (OR = 2.509, 95%CI: 1.173 - 5.370, P = 0.018) were risk factors for placental abruption in preeclampsia.

CONCLUSION

Lack of regular antenatal care, FGR, history of preeclampsia and second/third trimester pregnancy loss were risk factors associated with placental abruption in patients with preeclampsia.

摘要

目的

探讨子痫前期患者胎盘早剥的危险因素。

方法

回顾性分析1994年1月至2008年12月在北京大学第三医院治疗的219例患者的病历资料。患者分为3组,包括52例重度子痫前期伴胎盘早剥终止妊娠者、130例仅患有重度子痫前期者和37例无子痫前期的不明原因胎盘早剥者。选取178例正常妊娠者作为对照组(病例对照为1:2)。采用单因素和多因素回归分析确定子痫前期患者胎盘早剥的危险因素。

结果

(1)单因素分析显示,与对照组相比,妊娠次数、产次、子痫前期病史、孕中期和孕晚期流产史、自身免疫性疾病史、慢性高血压疾病、缺乏规律产前检查、胎儿生长受限(FGR)以及脐动脉多普勒阻力升高是与胎盘早剥相关的危险因素。Logistic回归分析显示,缺乏规律产前检查(OR = 45.348,95%CI:17.096 - 120.288,P = 0.000)、FGR(OR = 27.087,95%CI:5.585 - 131.363,P = 0.000)和孕中期/孕晚期流产史(OR = 16.068,95%CI:1.698 - 152.029,P = 0.015)是胎盘早剥的独立危险因素。(2)与无胎盘早剥的子痫前期患者相比,子痫前期病史(OR = 3.715,95%CI:1.096 - 12.596,P = 0.035)和缺乏规律产前检查(OR = 2.509,95%CI:1.173 - 5.370,P = 0.018)是子痫前期患者胎盘早剥的危险因素。

结论

缺乏规律产前检查、FGR、子痫前期病史和孕中期/孕晚期流产史是子痫前期患者胎盘早剥的相关危险因素。

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