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【目的】探讨产前死胎的相关危险因素。【方法】收集2011年1月-2015年12月中山大学附属第一医院收治的孕≥20周产前死胎病例74例作为死胎组,按1∶2的比例随机选取同期148例单胎活产分娩作为对照组。回顾病例资料,比较两组的临床特点,分析产前死胎的危险因素。采用t检验、卡方检验及Logistic回归分析进行统计学处理。【结果】无规范产检、流动人口、大专以下学历、胎动异常在死胎组的比率均高于对照组,两组相比差异均有统计学意义(P值分别为0.000、0.004、0.024、0.000),而年龄、孕前体质量指数、产次、稽留流产史及死胎史两组差异无统计学意义;妊娠期高血压疾病在死胎组的比率高于对照组,差异有统计学意义(P=0.000)。将有统计学差异的变量纳入单因素Logistic回归分析,结果发现,无规范产检、流动人口、大专以下学历、胎动异常及妊娠期高血压疾病者发生死胎的风险均增加,其OR值及95%CI分别为4.65(2.36~9.18)、2.46(1.32~4.61)、2.43(1.10~5.36)、211.32(47.64~937.30)、6.67(2.30~19.35)。【结论】无规范产检、流动人口、大专以下学历、胎动异常及妊娠期高血压疾病是产前死胎危险因素。加强公众尤其是流动人口健康教育及围产保健意识,及早发现、治疗妊娠期高血压疾病等高危妊娠可能有助于降低产前死胎的发生。
【Objective】 To explore the related risk factors of prenatal stillbirth. 【Methods】 Seventy-four cases of stillbirths less than 20 weeks pregnant from January 2011 to December 2015 in the First Affiliated Hospital of Sun Yat-sen University were enrolled as stillbirths. One hundred and eighty one single live births Childbirth as a control group. Reviewing the case data, the clinical characteristics of the two groups were compared to analyze the risk factors of prenatal stillbirth. Using t test, chi-square test and Logistic regression analysis for statistical analysis. 【Results】 There was no significant difference between the two groups (P = 0.000,0.004,0.024,0.000, respectively) in the rate of non-standardized birth control examination, floating population, education level below college degree and abnormal fetal movement rate in stillbirth group , While there was no significant difference in age, pre-pregnancy body mass index, parity, missed abortion history and stillbirth history; the rate of gestational hypertension in stillbirth group was higher than that in control group (P = 0.000 ). The inclusion of statistically significant variables in the single-factor Logistic regression analysis showed that there was an increased risk of stillbirth in non-standardized birth control, floating population, college education, fetal movement disorders and gestational hypertension, with an OR of 95% CI were 4.65 (2.36 ~ 9.18), 2.46 (1.32 ~ 4.61), 2.43 (1.10 ~ 5.36), 211.32 (47.64 ~ 937.30) and 6.67 (2.30 ~ 19.35), respectively. 【Conclusion】 Non-standardized birth control, floating population, college education, abnormal fetal movement and gestational hypertension are the risk factors of prenatal fetal death. To enhance public awareness of the health education of migrants and perinatal health care in particular, early detection and treatment of high-risk pregnancies such as hypertensive disorders during pregnancy may help reduce the incidence of stillbirths.