Department of Obstetrics and Gynecology, West China Xiamen Hospital of Sichuan University, Xiamen, Fujian Province, China.
Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China; Key Laboratory of Maternal-Fetal Medicine of Liaoning Province, Key Laboratory of Obstetrics and Gynecology of Higher Education of Liaoning Province, Benxi, China.
Placenta. 2022 Oct;128:62-68. doi: 10.1016/j.placenta.2022.08.060. Epub 2022 Sep 5.
To delineate obstetric complications and neonatal outcomes by maternal age in singleton pregnancies with previous caesarean section (CS).
A retrospective study involved 7715 singleton gestations with previous CS was conducted in a single centre. Statistical methods were used to describe and analyse the incidence of various complications and adverse outcomes classified by maternal ages. After selecting the reference group (30-34 years), multivariate logistic-binomial regression model was used to investigate the outcomes using SPSS.
From 2013 to 2017, the proportion of advanced maternal age (AMA, ≥35 years) women with a history of CS increased yearly, especially in the 35-39 years age group. AMA women accounted for 39.4% of all pregnancies and has a high incidence of in vitro fertilization(IVF), progesterone therapy in early pregnancy, pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), placenta previa, premature rupture of membranes (PROM) and postpartum haemorrhage (PPH). Compared to the 30-34 years group, the risks of PIH, GDM, placenta previa, PROM and PPH increased in AMA pregnancies. Very advanced age (≥40 years) may be associated with placenta accreta while young mothers (20-24 years) have a higher prevalence of premature birth. Vaginal bleeding during pregnancy is a risk factor for maternal complications, maternal and neonatal morbidity.
AMA is associated with increased risk of PIH, GDM, placenta previa, PROM and PPH. Vaginal bleeding may be a predictor during pregnancy.
本研究旨在探讨剖宫产术后再次妊娠的单胎妊娠中，产妇年龄对产科并发症及新生儿结局的影响。
本研究回顾性分析了单中心 7715 例剖宫产术后再次妊娠的单胎妊娠病例。采用统计学方法描述和分析了按产妇年龄分类的各种并发症和不良结局的发生率。在选择参考组（30-34 岁）后，使用 SPSS 中的多变量逻辑二项式回归模型来研究结局。
2013 年至 2017 年，有剖宫产史的高龄产妇（≥35 岁）的比例逐年增加，尤其是 35-39 岁年龄组。高龄产妇占所有妊娠的 39.4%，且 IVF、早孕孕激素治疗、妊娠高血压（PIH）、妊娠期糖尿病（GDM）、前置胎盘、胎膜早破（PROM）和产后出血（PPH）的发生率较高。与 30-34 岁组相比，高龄产妇（≥35 岁）发生 PIH、GDM、前置胎盘、PROM 和 PPH 的风险增加。非常高龄（≥40 岁）可能与胎盘粘连有关，而年轻母亲（20-24 岁）早产的发生率较高。妊娠期间阴道出血是产妇并发症、母婴发病率的危险因素。
高龄产妇（≥35 岁）与 PIH、GDM、前置胎盘、PROM 和 PPH 的风险增加相关。妊娠期间阴道出血可能是一个预测因素。
