巨大儿发生的相关因素对母婴的影响

巨大儿发生的相关因素对母婴的影响

目的探讨巨大儿发生的相关因素对母婴的影响。方法选取2012年1～10月在本院进行产前检查并住院分娩的201例巨大儿和205例正常体质量新生儿作为观察组与对照组，对两组孕前体质量、孕期增重、孕周、孕产次、宫高、孕妇腹围、双顶径、股骨长、胎儿腹围、分娩方式、母婴并发症发生率进行比较。结果两组孕产妇的孕前体质量、孕期增重、孕周、孕产次、宫高、腹围比较，差异有统计学意义（P＜0.05）。两组胎儿的双顶径、股骨长及腹围比较，差异有统计学意义（P＜0.05）。观察组产妇的剖宫产率及阴道助产率均高于对照组，自然分娩率低于对照组，差异有统计学意义（P＜0.05）。观察组的胎儿窘迫、产后出血、新生儿窒息、肩难产发生率均高于对照组，差异有统计学意义（P＜0.05）。结论应控制好孕期体质量增长，早期预防，加强孕期监护，正确产前诊断，选择正确的分娩方式，以降低母婴并发症发生率。

[Abstract] Objective To explore the impact of related factor of macrosomia occurrence on mother and infant. Methods 201 cases of macrosomia received prenatal examination and hospital delivery in our hospital from January 2012 to October 2012 were selected as observation group,while 205 cases of newborns of normal childbirth with normal weight for the same period were selected as control group.Pregnancy weight,weight gain during pregnancy,gestational week,maternal time,uterine height,abdominal perimeter,BPD,femur length,fetal abdominal perimeter,delivery methods,maternal and the incidence rate of complication of mother and infant in two groups was compared respectively. Results Pregnancy weight,weight gain during pregnancy,gestational week,maternal time,uterine height,abdominal perimeter of pregnant women in two groups was compared respectively,with statistical difference(P＜0.05).BPD,femur length,fetal abdominal perimeter of fetus in two groups was compared respectively,with statistical difference(P＜0.05).Cesarean section rate and the rate of vaginal delivery in observation group was higher than that in control group respectively,natural birth rate in observation group was lower than that in control group,with statistical difference(P＜0.05).The incidence rate of fetal distress,postpartum hemorrhage,neonatal asphyxia,shoulder dystocia in observation group was higher than that in control group respectively,with statistical difference(P＜0.05). Conclusion Weight gain during pregnancy should be controlled,early prevention is important,prenatal care should be strengthened,antenatal diagnosis should be accurate,delivery mode should be proper and gestational period complication should be decreased.

[Key words] Macrosomia;Related factor;Mother and infant

巨大儿是指出生体质量≥4000 g的活产新生儿。随着当今社会生活水平的提高，巨大儿发生率呈逐年上升趋势。研究表明，北京地区近20年巨大儿发生率上升5%[1]。作为产科常见的高危妊娠，巨大儿的发生增加了剖宫产率和母儿并发症发生率，且与出生后代谢性疾病相关，青春期后，与正常体质量儿相比，巨

大儿患肥胖和2型糖尿病的危险明显增加[2]。本研究主要探讨巨大儿发生的相关因素及预防措施，为正确决策和科学处理提供依据。

1 资料与方法

1.1 一般资料

选择2012年1～10月在本院进行产前检查并住院分娩的巨大儿201例作为观察组，选取同期正常体质量新生儿205例作为对照组，两组产妇年龄均为19～42岁，平均26岁。观察组分娩男胎130例（65%）、女胎71例（35%），对照组分娩男胎108例（52.7%）、女胎97例（47.3%），均为单胎足月妊娠。

1.2 研究方法

对孕产妇的孕前体质量、孕期增重、孕周、孕产次、宫高、腹围，胎儿的双顶径、股骨长、腹围，产妇分娩方式及母婴并发症发生情况进行记录并比较。

1.3 统计学处理

采用SPSS 12.0统计软件对数据进行分析和处理，计量资料以x±s表示，采用t检验，计数资料采用χ2检验，以P＜0.05为差异有统计学意义。

2 结果

2.1 两组孕产妇一般情况的比较

两组孕产妇的孕前体质量、孕期增重、孕周、孕产次、宫高、腹围比较，差异有统计学意义（P＜0.05）（表1）。

2.2 两组胎儿产前超声检查结果的比较

两组胎儿的双顶径、股骨长及腹围比较，差异有统计学意义（P＜0.05）（表2）。

表2 两组胎儿产前超声检查结果的比较（x±s）

2.3 两组产妇分娩方式的比较

观察组产妇的剖宫产率及阴道助产率均明显高于对照组，自然分娩率低于对照组，差异有统计学意义（P＜0.05）（表3）。

表3 两组产妇分娩方式的比较[n（%）]

2.4 两组母婴并发症发生率的比较