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足月胎膜早破危险因素的前瞻性巢式病例-对照研究

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目的 探讨足月胎膜早破(FPROM)的发生率及其危险因素.方法 选取2021年5月至2022年12月在珠海市妇幼保健院初次进行产前检查的孕妇及其配偶作为研究对象,将明确诊断为FPROM的孕妇纳入病例组,按1:3随机抽取同时期无FPROM的孕妇纳入对照组.通过问卷调查收集可能与FPROM发生有关的危险因素,通过医院的病历系统核对并记录妊娠结局.开展前瞻性巢式病例-对照研究并采用多因素Logistic回归方法分析和探讨FPROM发生的危险因素.结果 本研究FPROM发生率为24.27%.多因素Logistic回归分析结果提示,孕妇肥胖、吸烟、饮酒、不均衡饮食、进食槟榔、孕期未补充叶酸、孕期使用糖皮质激素和进行强体力活动、首次妊娠年龄大、不良妊娠或妊娠并发症史、糖尿病史或瘢痕子宫史、多次进行宫腔操作、多胎、羊水过多、横位、胎儿头盆不称以及配偶肥胖、吸烟和饮酒均为FPROM的危险因素(P<0.05);而孕妇孕次少和产次少均为FPROM的保护因素(P<0.05).结论 FPROM的危险因素较多,为了有效减少FPROM的发生率,尤其需重视孕妇的孕期生活行为习惯,加强对孕妇及其配偶的卫生宣教和指导,促使形成良好的生活习惯.
Risk factors for full-term prelabor rupture of membranes:a prospective nested case-control study
Objective To investigate the incidence of full-term prelabor rupture of membranes(FPROM)and risk factors for FPROM.Methods A prospective nested case-control study was performed on pregnant women in early pregnancy and their spouses,who underwent prenatal examination for the first time in Zhuhai Center for Maternal and Child Health Care from May 2021 to December 2022.Pregnant women with a clear diagnosis of FPROM were included in the case group,and pregnant women without FPROM were randomly selected at a 1:3 ratio for inclusion in the control group.A questionnaire survey was performed to collect exposure information possibly related to FPROM.The hospital's medical record system was used for information verification and to record the pregnancy outcomes.A multivariate logistic regression analysis was used to investigate the risk factors for FPROM.Results The incidence of FPROM in this study was 24.27%.The multivariate logistic regression analysis showed that obesity pregnant women,smoking,drinking,unbalanced diet,high-intensity physical activity during pregnancy,eating areca nut before pregnancy,using glucocorticoids during pregnancy,older at the time of first pregnancy,a history of adverse pregnancy outcomes,a history of pregnancy complications,a history of diabetes,a history of scar uterus,no folate supplementation during pregnancy,repeated intrauterine operations,polyembryony,polyhydramnios,transverse fetus and fetal cephalopelvic disproportion as the way of conception were risk factors for FPROM(P<0.05).Additionally,the pregnant women whose spouses were obese or smoked or drinking had an increased risk of FPROM(P<0.05).Lower gravidity and lower parity were protective factors against FPROM(P<0.05).Conclusion There are many risk factors for FPROM.Special attention should be given to the life behaviors of pregnant women during pregnancy,and health education should be strengthened for pregnant women and their spouses to help them develop good living habits and reduce the incidence of FPROM.

Full-term prelabor rupture of membranesRisk factorProspective nested case-control studyPregnant woman

伍高红、纪庆阳、史源、马飞、姜春明、朱雪萍

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珠海市妇幼保健院新生儿科(广东珠海 519000)

重庆医科大学附属儿童医院新生儿科,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室(重庆 400000)

苏州大学附属儿童医院新生儿科(江苏苏州 215000)

足月胎膜早破 危险因素 前瞻性巢式病例-对照研究 孕妇

国家自然科学基金项目

81971423

2024

中国循证医学杂志
四川大学

中国循证医学杂志

CSTPCD北大核心
影响因子:1.761
ISSN:1672-2531
年,卷(期):2024.24(1)
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