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目的探讨高危妊娠与胎盘病理缺氧性改变的关系及对早产儿结局的影响。方法回顾性分析2011年6月-2015年6月在南方医院产科分娩并行胎盘病理检查的28~33+6周单胎孕妇共342例,根据孕妇有无高危因素分为高危组和对照组,对两组胎盘病理缺氧性改变及早产儿结局进行分析。结果高危组胎盘病理缺氧性改变明显高于对照组(P<0.05)。Logistic回归分析显示,妊娠期高血压疾病是胎盘病理缺氧性改变的高危因素(OR=2.527,P<0.05);高危组早产儿出生体重明显低于对照组(P<0.05),死胎、剖宫产、小于胎龄、胎儿窘迫、严重新生儿发病率及围生期死亡率明显高于对照组(P<0.05)。结论高危妊娠孕妇,早产胎盘病理缺氧性改变可能预示子宫胎盘血流灌注不足,并会导致新生儿不良结局。
Objective To investigate the relationship between high-risk pregnancy and placental hypoxia and its effect on the outcomes of premature infants. Methods A total of 342 pregnant women with 28 ~ 33 + 6 weeks of single placenta pathological examination during the obstetric delivery in Nanfang Hospital from June 2011 to June 2015 were retrospectively analyzed. According to the presence or absence of high risk factors, pregnant women were divided into high risk group and control group, Two groups of placenta hypoxic changes and the outcome of premature children were analyzed. Results High-risk group placental hypoxia changes significantly higher than the control group (P <0.05). Logistic regression analysis showed that hypertensive disorder complicating pregnancy was the risk factor for placental hypoxia (OR = 2.527, P <0.05). The birth weight of preterm infants in high risk group was significantly lower than that in control group (P <0.05) Palace, less than gestational age, fetal distress, severe neonatal morbidity and perinatal mortality was significantly higher than the control group (P <0.05). Conclusions In pregnant women with high-risk pregnancies, the changes of placental hypoxemia in preterm labor may indicate insufficient perfusion of uteroplacental placenta and lead to poor outcomes in neonates.