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医疗保健服务的改善对青少年女性的产科结局有影响吗?

Has improved health care provision impacted on the obstetric outcome in teenage women?

作者信息

Lao Terence T, Suen Stephen Sik Hung, Sahota Daljit S, Wa Law Lai, Yeung Leung Tak

机构信息

Department of Obstetrics and Gynaecology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, PRC.

出版信息

J Matern Fetal Neonatal Med. 2012 Aug;25(8):1358-62. doi: 10.3109/14767058.2011.634460. Epub 2012 May 11.

Abstract

OBJECTIVE

To determine the obstetric outcome in teenage women managed in the recent decade with easily accessible health care provision.

METHODS

In a retrospective cohort study, maternal demographics, underlying medical conditions, obstetric complications, preterm birth, type of labor, mode of delivery, and perinatal mortality were compared between 1505 women aged ≤ 19 years (study group) with 10,320 women aged 20-24 years (comparison group), who were carrying singleton pregnancies beyond 24 weeks of gestation and managed in our hospital between January 1998 and June 2008.

RESULTS

The study and comparison groups accounted for 2.2% and 15.1% respectively of the total deliveries. Despite comparable health status and rates of other obstetric complications, teenage women was associated with birth <34 weeks (aOR 2.45, 95% CI 1.67-3.60), birth at 34-36 weeks (aOR 2.13, 95% CI 1.71-2.65), and reduced instrumental vaginal (aOR 0.62, 95% CI 0.50-0.77) and caesarean (aOR 0.79, 95% CI 0.64-0.97) delivery, without increase in perinatal mortality.

CONCLUSIONS

Teenage women had increased preterm birth, despite improved health care provision, nutrition, and similar incidence of other obstetric complications, but the obstetric and perinatal outcome remained favorable.

摘要

目的

确定近十年在易于获得医疗保健服务的情况下,青少年女性的产科结局。

方法

在一项回顾性队列研究中,对1505名年龄≤19岁的女性(研究组)和10320名年龄在20 - 24岁的女性(对照组)的孕产妇人口统计学特征、基础疾病、产科并发症、早产、分娩类型、分娩方式和围产期死亡率进行了比较。这些女性均为单胎妊娠,孕周超过24周,于1998年1月至2008年6月在我院接受治疗。

结果

研究组和对照组分别占总分娩数的2.2%和15.1%。尽管健康状况和其他产科并发症发生率相当,但青少年女性与<34周出生(调整后比值比[aOR] 2.45,95%置信区间[CI] 1.67 - 3.60)、34 - 36周出生(aOR 2.13,95% CI 1.71 - 2.65)相关,且阴道助产(aOR 0.62,95% CI 0.50 - 0.77)和剖宫产(aOR 0.79,95% CI 0.64 - 0.97)分娩减少,围产期死亡率未增加。

结论

尽管医疗保健服务、营养状况有所改善,且其他产科并发症发生率相似,但青少年女性早产率仍有所增加,不过产科和围产期结局仍然良好。

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