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沙特阿拉伯吉达一家三级医院高龄产妇的妊娠结局。

Pregnancy outcomes at advanced maternal age in a tertiary Hospital, Jeddah, Saudi Arabia.

机构信息

From the Department of Obstetrics and Gynecology, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, Kingdom of Saudi Arabia.

出版信息

Saudi Med J. 2022 May;43(5):491-499. doi: 10.15537/smj.2022.43.5.20220023.

Abstract

OBJECTIVES

To evaluate obstetrical and fetal outcomes among advanced maternal age (AMA) women.

METHODS

Retrospective cohort study carried out at a teaching hospital, Jeddah, Saudi Arabia, during 18 years period (from January 2003 until December 2020). A total of 79095 women gave birth, and randomized block was used to include 4318 singleton pregnancy women (>28 gestational weeks), of them 2162 age ≥40 years. Associations between AMA and obstetrical and fetal parameters were assessed.

RESULTS

Advanced maternal age independently associated with non-Saudi national, mother's weights 80-99 kg, diabetes mellitus, and hypertension. Advanced maternal age mothers were more liable to premature rupture of membranes (PROM), caesarean (CS) deliveries, and postpartum hemorrhage. Newborn of AMA women were at high risk of birth weight <2500 g, birth weight 3600-4500 g, decline Apgar score at 5 minutes, and neonatal intensive care unit (NICU) admissions.

CONCLUSION

Advanced maternal age is an independent risk factor for adverse obstetric hazards as CS, antepartum haemorrhage, diabetes mellitus, hypertension, PROM, postpartum hemmorage, and fetal complications as low birth weight, macrosomia, NICU admission, congenital anomalies, and low Apgar score. These results must be carefully considered by maternal care providers to effectively improve clinical surveillance.

摘要

目的

评估高龄产妇的产科和胎儿结局。

方法

这是在沙特阿拉伯吉达的一所教学医院进行的回顾性队列研究,研究时间为 18 年(2003 年 1 月至 2020 年 12 月)。共有 79095 名妇女分娩,采用随机分组的方法纳入了 4318 名单胎妊娠妇女(>28 孕周),其中 2162 名年龄≥40 岁。评估了高龄产妇与产科和胎儿参数之间的关系。

结果

高龄产妇与非沙特籍、母亲体重 80-99kg、糖尿病和高血压独立相关。高龄产妇更容易发生胎膜早破(PROM)、剖宫产(CS)分娩和产后出血。高龄产妇的新生儿出生体重<2500g、出生体重 3600-4500g、5 分钟时 Apgar 评分下降以及新生儿重症监护病房(NICU)入院的风险较高。

结论

高龄产妇是 CS、产前出血、糖尿病、高血压、PROM、产后出血和胎儿并发症(如低出生体重、巨大儿、NICU 入院、先天性畸形和低 Apgar 评分)等不良产科风险的独立危险因素。这些结果必须由产妇护理提供者仔细考虑,以有效改善临床监测。

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