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晚期妊娠的发生率及结局

The Incidence and Outcomes of Late-Term Pregnancy.

作者信息

Ranjbar Amene, Mehrnoush Vahid, Darsareh Fatemeh, Pariafsay Faranak, Shirzadfardjahromi Malihe, Shekari Mitra

机构信息

Fertility and Infertility Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, IRN.

Urology Department, Northern Ontario School of Medicine, Thunder Bay, CAN.

出版信息

Cureus. 2023 Jan 9;15(1):e33550. doi: 10.7759/cureus.33550. eCollection 2023 Jan.

Abstract

BACKGROUND

Little is known about the outcomes of late-term pregnancy. In this study, we aim to assess the incidence and adverse prenatal outcomes associated with late-term pregnancy.

METHODS

We retrospectively assessed all singleton pregnant mothers who gave birth at Khalij-e-Fars Hospital in Bandar Abbas, Iran, between January 2020 and 2022. All preterm and post-term deliveries were excluded. Mothers were divided into two groups: late-term mothers (41 0/7-41 6/7 weeks of gestation) and term mothers (37 0/7-40 6/7 weeks of gestation). Demographic factors, obstetric factors, maternal comorbidities, and prenatal outcomes were extracted from the electronic data of each mother. The incidence of late-term births was calculated. The chi-squared test was used to compare differences between the groups. Logistic regression models were used to assess the association of prenatal outcome with late-term pregnancy.

RESULTS

There were 8,888 singleton deliveries during the study period, and 1,269 preterm and post-term pregnancies were ruled out. Of the 7,619 deliveries, 309 (4.1%) were late-term, while 7,310 (95.9%) were term. There were no sociodemographic differences between term and late-term mothers. The late-term group had a higher prevalence of primiparous mothers, and the term group had a higher prevalence of diabetes. Late-term mothers had a higher risk of macrosomia (adjusted odds ratio (aOR): 2.24 (95% confidence interval (CI): 1.34-3.01)), meconium amniotic fluid (aOR: 2.32 (95% CI: 1.59-3.14)), and fetal distress (aOR: 2.38 (95% CI: 1.54-2.79)). When compared to term pregnancy, the risk of low birth weight (LBW) was lower in late-term pregnancy (aOR: 0.69 (95% CI: 0.36-0.81)).

CONCLUSIONS

Late-term pregnancy was found to be more likely to be associated with macrosomia, meconium amniotic fluid, and fetal distress, but serious maternal and neonatal adverse events were comparable to term pregnancy.

摘要

背景

关于晚期妊娠的结局知之甚少。在本研究中,我们旨在评估晚期妊娠的发生率及相关不良产前结局。

方法

我们回顾性评估了2020年1月至2022年期间在伊朗阿巴斯港的哈利季-法尔斯医院分娩的所有单胎妊娠母亲。排除所有早产和过期产。母亲们被分为两组:晚期妊娠母亲(妊娠41 0/7 - 41 6/7周)和足月妊娠母亲(妊娠37 0/7 - 40 6/7周)。从每位母亲的电子数据中提取人口统计学因素、产科因素、母亲合并症和产前结局。计算晚期出生的发生率。采用卡方检验比较两组之间的差异。使用逻辑回归模型评估产前结局与晚期妊娠的关联。

结果

在研究期间共有8888例单胎分娩,排除1269例早产和过期产妊娠。在7619例分娩中,309例(4.1%)为晚期妊娠,而7310例(95.9%)为足月妊娠。足月妊娠母亲和晚期妊娠母亲在社会人口统计学方面无差异。晚期妊娠组初产妇的患病率较高,足月妊娠组糖尿病的患病率较高。晚期妊娠母亲发生巨大儿(调整优势比(aOR):2.24(95%置信区间(CI):1.34 - 3.01))、羊水粪染(aOR:2.32(95% CI:1.59 - 3.14))和胎儿窘迫(aOR:2.38(95% CI:1.54 - 2.79))的风险较高。与足月妊娠相比,晚期妊娠发生低出生体重(LBW)的风险较低(aOR:0.69(95% CI:0.36 - 0.81))。

结论

研究发现,晚期妊娠更有可能与巨大儿、羊水粪染和胎儿窘迫相关,但严重的母婴不良事件与足月妊娠相当。

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