子痫前期合并胎儿生长受限的母儿妊娠结局分析

Analysis of Maternal and Infant Pregnancy Outcomes in Preeclampsia Combined with Fetal Growth Restriction

摘要: 目的：探讨子痫前期(Preeclampsia, PE)合并胎儿生长受限(Fetal growth restriction, FGR)的母儿妊娠结局。方法：选取2019年1月至2020年1月于青岛妇女儿童医院分娩的295例子痫前期孕妇为研究对象，对其临床资料进行回顾性分析，按是否合并胎儿生长受限分为FGR组(49例)和非FGR组(246例)，比较两组孕妇的一般情况、母体妊娠结局及围产儿结局。结果：与非FGR组相比，FGR组诊断子痫前期的孕周周数较早(P < 0.05)。FGR组孕妇的低蛋白血症发生率、胎盘早剥发生率、羊水过少发生率、因胎儿窘迫行剖宫产的比率增加(P < 0.05)，两组孕妇产后出血发生率、HELLP综合征发生率、剖宫产率的比较，差异均无统计学意义(P < 0.05)。FGR组的围产儿出生体重、新生儿Apgar评分(1分钟及5分钟)均低于非FGR组，差异有统计学意义(P < 0.05)。与非FGR组相比，FGR组的早产、低出生体重儿、新生儿窒息、新生儿贫血、新生儿败血症、新生儿肠炎、新生儿肺炎、先天性心脏病的发生率增加，差异有统计学意义(P < 0.05)。FGR组的NICU收治率较高(P < 0.05)，住院天数较长(P < 0.05)。结论：PE合并FGR孕妇的发病孕周更早，母儿不良妊娠结局的发生率增加。故应加强对PE合并FGR孕妇的母儿监护，选择合适的分娩时机和分娩方式，从而改善母儿结局。

Abstract: Objective: To investigate the pregnancy outcome of preeclampsia (PE) with fetal growth restriction (FGR). Methods: 295 cases of preeclampsia pregnant women who delivered in Qingdao Women and Children’s Hospital from January 2019 to January 2020 were selected as the research objects, and their clinical data were retrospectively analyzed. According to whether they were combined with fetal growth restriction, they were divided into FGR group (49 cases) and non FGR group (246 cases). Results: Compared with non FGR group, FGR group had earlier gestational weeks (P < 0.05). The incidence of hypoproteinemia, placental abruption, oligohydramnios and cesarean section due to fetal distress increased in FGR group (P < 0.05). There was no significant difference in the incidence of postpartum hemorrhage, HELLP syndrome and cesarean section rate between the two groups (P < 0.05). The perinatal birth weight and Apgar score (1 minute and 5 minutes) in FGR group were lower than those in non FGR group (P < 0.05). Compared with the non FGR group, the incidence of preterm birth, low birth weight infants, neonatal asphyxia, neonatal anemia, neonatal sepsis, neonatal enteritis, neonatal pneumonia and congenital heart disease in FGR group were increased (P < 0.05). The admission rate of NICU in FGR group was higher (P < 0.05), and the length of hospital stay was longer (P < 0.05). Conclusion: The gestational weeks of PE combined with FGR are earlier, and the incidence of adverse pregnancy outcomes is increased. Therefore, it is necessary to strengthen the maternal and child monitoring of PE combined with FGR, and to select the appropriate delivery time and mode, so as to improve the maternal and child outcomes.