[1]谷新喜,潘　莹,杨秀林.孤立性羊水过少和孤立性临界羊水过少足月妊娠母婴结局分析[J].新乡医学院学报,2021,38(6):564-569.[doi:10.7683/xxyxyxb.2021.06.014]
　GU Xinxi,PAN Ying,YANG Xiulin.Maternal and perinatal outcomes at term pregnancy with isolated oligohydramnios and isolated borderline oligohydramnios[J].Journal of Xinxiang Medical University,2021,38(6):564-569.[doi:10.7683/xxyxyxb.2021.06.014]
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孤立性羊水过少和孤立性临界羊水过少足月妊娠母婴结局分析
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年6
页码:
564-569
栏目:
临床研究
出版日期:
2021-06-05

文章信息/Info

Title:
Maternal and perinatal outcomes at term pregnancy with isolated oligohydramnios and isolated borderline oligohydramnios
作者:
谷新喜; 潘　莹; 杨秀林
（新乡医学院第三附属医院妇产科，河南　新乡　453003）
Author(s):
GU Xinxi; PAN Ying; YANG Xiulin
(Department of Obstetrics and Gynecology，the Third Affiliated Hospital of Xinxiang Medical University，Xinxiang 453003，Henan Province，China)
关键词:
孤立性羊水过少; 孤立性临界羊水过少; 足月妊娠; 围产儿结局羊水指数
Keywords:
isolated oligohydramnios; isolated borderline oligohydramnios; term pregnancy; perinatal outcome; amniotic fluid index
分类号:
R714
DOI:
10.7683/xxyxyxb.2021.06.014
文献标志码:
A
摘要:
目的　探讨孤立性羊水过少(IO)和孤立性临界羊水过少(IBO）对足月产妇母婴结局的影响。方法　选择2017年12月至2019年4月于新乡医学院第三附属医院分娩的1 037例足月单胎产妇为研究对象，根据羊水指数（AFI）分为IO组(n=143)、IBO组(n=236)和羊水量正常(NAF)组(n=658)，查阅病历收集其一般资料和母婴结局。比较3组产妇的母婴结局，包括剖宫产率、剖宫产原因、新生儿 5 min Apgar 评分＜7分比例、低体质量儿比例、羊水粪染率、入住新生儿重症监护室(NICU)率和新生儿死亡数，并采用logistic回归分析其相关因素，采用Pearson检验分析AFI与新生儿体质量之间的相关性。结果　3组产妇孕周比较差异无统计学意义(P＞0.05)。IO组、IBO组产妇年龄均小于NAF组 (P＜0.016)；IO组与IBO组产妇的年龄比较差异无统计学意义(P＞0.016)。IO组、IBO组、NAF组初产妇比例分别为67.1%(96/143)、56.8%(134/236)、43.7%(288/658)，IO组、IBO组初产妇比例均高于NAF组(P＜0.016)，IO组与IBO组初产妇比例比较差异无统计学意义(P＞0.016)。IO组、IBO组、NAF组产妇引产率分别为33.6%(48/143)、34.7%(82/236)、19.1%(126/658)，IO组、IBO组产妇引产率均高于NAF组(P＜0.016)，IO组与IBO组产妇引产率比较差异无统计学意义(P＞0.016)。IO组、IBO组、NAF组产妇剖宫产率分别为49.6%(71/143)、29.2% (69/236)、21.2%(140/658)，IO组、IBO组产妇剖宫产率高于NAF组(P＜0.016)，IO组产妇剖宫产率高于IBO组 (P＜0.016)。3组新生儿均无死亡，羊水粪染率、低出生体质量儿比例、新生儿5 min Apgar评分＜7分比例和入住NICU率比较差异均无统计学意义(P＞0.05)；IO组、IBO组新生儿体质量低于NAF组(P＜0.016)，IO组新生儿体质量均低于IBO组 (P＜0.016)。Pearson检验分析结果显示，AFI与新生儿出生体质量呈正相关(r=0.224，P＜0.001)。校正孕周、年龄和初产妇等因素后logistic回归分析结果显示，选择性引产和IO为剖宫产分娩率升高的相关因素(P＜0.05)；选择性引产是可疑电子胎心率监护(NRFHR)的影响因素 (P＜0.05)，而IO与NRFHR无相关性 (P＞0.05)；选择性引产和IO均不是产妇选择剖宫产分娩的相关因素(P＞0.05)。结论　AFI与新生儿出生体质量有关，IO和IBO与不良围产儿结局无关，IO和选择性引产均会增加产妇的剖宫产率，而选择性引产通过增加NRFHR来增加剖宫产率。对IBO或IO足月产妇减少引产干预能大幅度降低剖宫产率，在严密的产科监测下继续妊娠可能更有利于胎儿进一步生长发育。
Abstract:
Objective　To investigate the maternal and perinatal outcomes of term pregnancies with isolated oligohydramnios (IO) and isolated borderline oligohydramnios (IBO).Methods　　A total of 1 037 term and singleton pregnancies who delivered in the Third Affiliated Hospital of Xinxiang Medical University from December 2017 to April 2019 were selected as the research subjects,and they were divided into the IO group (n=143)，IBO group (n=236) and normal amniotic fluid (NAF) group (n=658) according to the amniotic fluid index (AFI);and their general informations,maternal and neonatal outcomes were collected by consulting medical records.The maternal and perinatal outcomes including the cesarean section rate,the cause of cesarean section,the proportion of newborn infants of Apgar score＜7 at five minutes,the proportion of low birth weight infants,the rate of meconium-stained amniotic fluid,the rate of newborn infants admission to neonatal intensive care unit and the number of neonatal deaths were compared among the three groups.Logistic regression was used to analyze the related factors of maternal and perinatal outcomes.The correlation between AFI and neonatal birth weight was analyzed by Pearson correlation analysis.Results　There was no significant difference in gestational weeks among the three groups (P>0.05).The maternal age in the IO group and IBO group was significantly lower than that in the NAF group (P<0.016);there was no significant difference in maternal age between the IO group and IBO group (P>0.016).The proportion of primipara in the IO group,IBO group and NAF group was 67.1%(96/143),56.8%(134/236) and 43.7%(288/658),respectively.The proportion of primipara in the IO group and IBO group was significantly higher than that in the NAF group (P<0.016);there was no significant difference in the proportion of primipara between the IO group and IBO group (P>0.016).The labor induction rate in the IO group,IBO group and NAF group was 33.6%(48/143),34.7%(82/236) and 19.1%(126/658),respectively.The labor induction rate in the IO group and IBO group was significantly higher than that in the NAF group (P<0.016);there was no significant difference in labor induction rate between the IO group and IBO group (P>0.016).The rate of cesarean section in the IO group,IBO group and NAF group was 49.6%(71/143),29.2% (69/236) and 21.2%(140/658),respectively.The rate of cesarean section in the IO group and IBO group was significantly higher than that in the NAF group (P<0.016);the rate of cesarean section in the IO group was significantly higher than that in the IBO group (P<0.016).There was no neonatal death in the three groups.There was no significant difference in the rate of meconium-stained amniotic fluid,the proportions of low birth weight infants，the rate of newborn infants of Apgar score＜7 at five minutes and the rate of newborn infants admission to neonatal intensive care unit among the three groups (P>0.05).The neonatal weight in the IO group and IBO group was significantly lower than that in the NAF group (P<0.016).Pearson correlation analysis results showed that the AFI was positively correlated with the neonatal weight (r=0.224，P<0.001).After adjusting for age，gestional weeks and nullipara，the results of logistic regression analysis showed that selective induced labor and IO were the related factors for increasing the cesarean delivery rate(P<0.05)；selective induced labor was the influencing factor for the nonreassuring fetal heart rate monitoring (NRFHR) (P<0.05),but the IO was not correlated with the NRFHR (P>0.05).Selective induced labor and IO were no the related factors of cesarean delivery (P>0.05).Conclusion　AFI is related to neonatal birth weight.IO and IBO are not related to adverse perinatal outcomes.IO and selective induced labor can increase cesarean delivery rate,and selective induced labor can increase cesarean delivery rate by increasing NRFHR.Reducing induced labor intervention for IBO or IO term pregnacies can significantly reduce the cesarean delivery rate.Under close obstetric supervision,continued pregnancy may be more conducive to the further growth and development of the fetus.

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更新日期/Last Update: 2021-06-05