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澳大利亚维多利亚州高龄产妇与产科发病率:一项基于人群的研究。

Advanced maternal age and obstetric morbidity for women giving birth in Victoria, Australia: A population-based study.

作者信息

Biro Mary Anne, Davey Mary-Ann, Carolan Mary, Kealy Michelle

机构信息

School of Nursing and Midwifery, Clayton Campus, Monash University, Clayton.

出版信息

Aust N Z J Obstet Gynaecol. 2012 Jun;52(3):229-34. doi: 10.1111/j.1479-828X.2012.01427.x. Epub 2012 Apr 13.

Abstract

BACKGROUND

As the proportions of older women giving birth increase, there is a growing body of evidence on the increased risks of poorer maternal and perinatal outcomes for this group. However, the associations are not completely understood. This study aimed to establish the prevalence of selected maternal morbidities and examine whether advanced maternal age is associated with a higher risk of morbidity for women giving birth in Victoria.

METHOD

Data on all births over 20 weeks‧ gestation for 2005 and 2006 were obtained from the Victorian Perinatal Data Collection. Unadjusted and adjusted analyses were undertaken using logistic regression to examine and quantify the association between advanced maternal age (35 years and older) and selected obstetric morbidities and complications.

RESULTS

There was evidence of an association between older maternal age and selected morbidities and complications. Older nulliparous women were at highest odds of gestational diabetes (AdjOR, 1.83; 95% CI, 1.67-2.02), placenta praevia (AdjOR, 2.02; 95% CI, 1.68-2.44), multiple birth (AdjOR, 1.80; 95% CI, 1.58-2.06) and caesarean delivery (AdjOR, 1.93; 95% CI, 1.84-2.02). Older multiparous women were at highest odds of gestational diabetes (AdjOR, 2.01; 95% CI, 1.88-2.15) and placenta praevia (AdjOR, 2.11; 95% CI, 1.83-2.44).

CONCLUSIONS

Older women giving birth in Victoria are at an increased risk of a range of obstetric morbidities. Delayed childbearing for an increasing number of women has societal and public health ramifications and will potentially place greater demand on healthcare services.

摘要

背景

随着高龄产妇分娩比例的增加,有越来越多的证据表明该群体孕产妇及围产期结局较差的风险增加。然而,这些关联尚未完全明确。本研究旨在确定特定孕产妇疾病的患病率,并探讨高龄产妇是否与维多利亚州分娩女性的更高发病风险相关。

方法

从维多利亚州围产期数据收集中获取2005年和2006年所有孕周超过20周的分娩数据。采用逻辑回归进行未调整和调整分析,以检验和量化高龄产妇(35岁及以上)与特定产科疾病及并发症之间的关联。

结果

有证据表明高龄产妇与特定疾病及并发症之间存在关联。年龄较大的未生育女性患妊娠期糖尿病(调整比值比[AdjOR],1.83;95%置信区间[CI],1.67 - 2.02)、前置胎盘(AdjOR,2.02;95% CI,1.68 - 2.44)、多胎妊娠(AdjOR,1.80;95% CI,1.58 - 2.06)及剖宫产(AdjOR,1.93;95% CI,1.84 - 2.02)的几率最高。年龄较大的经产妇患妊娠期糖尿病(AdjOR,2.01;95% CI,1.88 - 2.15)和前置胎盘(AdjOR,2.11;95% CI,1.83 - 2.44)的几率最高。

结论

在维多利亚州分娩的高龄女性患一系列产科疾病的风险增加。越来越多女性推迟生育具有社会和公共卫生影响,并可能对医疗服务提出更大需求。

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