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目的:探讨稽留流产发生的高危因素。方法:通过病例-对照回顾性研究,收集稽留流产病例1 945例,同时与1 874例因非意愿妊娠20周内的单活胎要求终止妊娠者(包括妊娠<12周自愿要求终止妊娠者以及妊娠12~20周内因内外科因素不宜妊娠者)的病例资料进行对比。分析与稽留流产发病相关的高危因素及环境等因素在稽留流产中可能产生的影响。结果:1Logistic多因素回归分析显示,与1 945例稽留流产发病正相关的危险因素包括:室外职业者(OR=1.777,95%CI=1.538~2.052),初产妇(OR=2.305,95%CI=2.013~2.638),自然流产史(OR=2.359,95%CI=1.703~3.268),贫血(OR=5.498,95%CI=2.243~13.473),乙肝病毒携带者(OR=8.126,95%CI=4.688~14.084);与稽留流产发病负相关的危险因素为人工流产≥3次(OR=0.726,95%CI=0.573~0.920)。2稽留流产独立因素构成变化显示,环境因素及一些未知因素等构成比升高(P<0.05),与稽留流产发病数增加有关。结论:室外职业者、初产妇、自然流产病史、贫血和乙肝病毒携带者是稽留流产发生的独立危险因素,其中环境因素及一些未知因素的构成比随稽留流产发病数增加而升高。初步推论:基因、生育史、合并症不能解释稽留流产发病数的升高,而环境因素和一些未知因素可能是稽留流产病例数升高的重要原因之一。
Objective: To explore the risk factors of missed abortion. METHODS: A case-control retrospective study was conducted to collect 1 945 cases of missed abortion and 1 874 cases of termination of pregnancy due to single live fetus within 20 weeks of unintended pregnancy (including those who volunteered to terminate their pregnancy <12 weeks of gestation and Pregnancy 12 to 20 weeks because of internal and external factors should not be pregnant pregnancy) data were compared. Analysis of the risk factors associated with missed abortion and environmental factors may have a residual abortion in the impact. Results: 1 Logistic multivariate regression analysis showed that the risk factors positively correlated with the incidence of 1 495 missed abortions were: outdoor occupations (OR = 1.777, 95% CI = 1.538-2.0252), primipara (OR = 2.305, 95% CI = 2.013-2.638), history of spontaneous abortion (OR = 2.359, 95% CI = 1.703-3.268), anemia (OR = 5.498, 95% CI = 2.243-13.473), hepatitis B virus carriers = 4.688 ~ 14.084). The negative risk factor for missed abortion was ≥3 times (OR = 0.726, 95% CI = 0.573 ~ 0.920). Changes in the composition of independent factors of missed abortion showed that the environmental factors and some unknown factors such as the composition ratio increased (P <0.05), and increased the incidence of missed abortion. Conclusion: Outdoor workers, primipara, the history of spontaneous abortion, anemia and hepatitis B virus carriers are independent risk factors for missed abortion. The composition of environmental factors and some unknown factors increase with the increase of the number of aborted abortion. Preliminary inference: Gene, fertility history, comorbidities can not explain the rise in the number of missed abortion, and environmental factors and some unknown factors may be one of the important reasons for the increased number of missed abortion cases.