摘要【目的】分析未婚青少年孕妇妊娠结局的现状。【方法】回顾性分析2013年1月至2020年12月在本院住院分娩的11~19岁青少年孕妇(青少年组)和20岁以上成人孕妇(成人组)的临床特征和妊娠结局,比较两组妊娠合并症和并发症、不良妊娠结局、分娩方式的差异,计算相对危险度。【结果】青少年组孕妇743例,数量及占比呈逐年下降趋势;与成人组相比,青少年组孕妇本地人口占比(64.1% vs 90.9%)更低,经产妇占比(7.1% vs 34.3%)更低,阴道分娩比例(68.1% vs 46.6%)更高,平均分娩孕周[(39.6±1.7)周 vs (39.1±1.4)周]更晚,新生儿出生体重[(3304.9±465.4)g vs (3356.3±443.1)g]更轻,住院费用[(6594.2±3012.7)元 vs (8547.8±3694.0)元]更低,差异均有统计学意义(P<0.05)。与成人组孕妇比较,青少年组孕妇贫血、子痫前期发生率更高(P<0.05),妊娠期糖尿病、甲状腺功能减退发生率更低(P<0.05);与20~34岁成人组孕妇比较,青少年组妊娠期高血压疾病发生率亦更高(P<0.05)。青少年组新生儿窒息发生率高于成人组(P<0.05),两组其他母婴结局比较,差异无统计学意义(P>0.05)。【结论】青少年孕妇贫血、妊娠期高血压疾病、新生儿窒息发生率高于成人孕妇。虽然青少年住院分娩数呈下降趋势,但仍需关注青少年性教育,避免非意愿妊娠;关爱青少年孕妇,减少母婴不良结局发生。
Abstract:【Objective】To investigate whether unmarried adolescent pregnant women have higher rates of pregnancy complications and comorbidities, and explore the impact on maternal and infant outcomes. 【Methods】A retrospective cohort study was conducted on the general characteristics and pregnancy outcomes of adolescent pregnant women aged 11-19 years and adult pregnant women over 20 years old who were hospitalized in our hospital from January 2013 to December 2020. A comparison of pregnancy complications, adverse pregnancy outcomes, and delivery methods was made, and relative risks were calculated. 【Results】There were 743 pregnant women in the adolescent group, and the number and proportion showed a downward trend year by year.The proportion of pregnant women in the adolescent group was lower in the local population (64.1% vs 90.9%), lower proportion of multiparas (7.1% vs 34.3%), higher proportion of vaginal delivery (68.1% vs 46.6%). The average delivery gestational age was [(39.6±1.7) weeks vs (39.1±1.4) weeks], the birth weight of new-borns was [(3304.9±465.4) g vs ( 3356.3±443.1) g], and hospitalization expenses was [(6594.2±3012.7) yuan vs (8547.8±3694.0) yuan] as the adolescent pregnant group vs the adult pregnant group; And the differences were statistically significant (P<0.05).The adolescent group had higher rates of anemia and preeclampsia, while gestational diabetes and hypothyroidism were less common. When compared to adults aged 20-34 years, the incidence of hypertensive disorders during pregnancy was also higher in the adolescent group. The incidence of neonatal asphyxia in the adolescent group was higher than that in the adult group. There was no significant difference in other maternal and infant outcomes between the two groups. 【Conclusion】The incidence of anemia and gestational hypertension in adolescents is higher than that in adults, and the incidence of neonatal asphyxia is higher than that in adults. Despite the declining rate of hospital deliveries of adolescent pregnancy, it is vital to pay attention to adolescent sex education in order to prevent unintended pregnancy, and it is necessary to care for adolescent pregnant women in order to reduce adverse outcomes for the mother and infant.
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