摘要目的 了解胎盘早剥的危险因素和流行病学特点.方法 采用横断面研究方法,收集2013年1月1日至2016年12月31日期间河北省22所监测医院入院分娩的218 880例孕产妇资料.分析胎盘早剥的流行病学特征、时间分布、人口分布、地域分布和胎盘早剥的危险因素.结果 218 880例孕产妇中诊断为胎盘早剥者669例(0.31％);不同地区发生率整体趋势符合南高北低、区域性经济中心高于周边地区;省市级医院患病率高于县乡级,医院等级越高发生率越高;发病年龄(27.87±4.50)岁,孕妇年龄的发生率呈“J”型分布,多因素回归分析显示:妊娠合并高血压(OR=1.65,95％CI:1.09 ～ 2.50),轻度子痫前期(OR=3.65,95％CI:2.40～5.56),重度子痫前期(OR=4.72,95％CI:3.86～ 5.76)和贫血(OR=2.41,95％CI:2.05～2.83)是胎盘早剥的独立危险因素.结论 胎盘早剥患病率在＜20岁和≥35岁都较高,建议适度孕育,针对不同地区,尤其是高危人群采取预防措施,加强监测,对改善围产结局具有重要意义.

abstractsObjective The aim of this study was to assess the risk factors and epidemiological characteristics of placental abruption (PA) in Hebei province.Methods A cross-sectional survey was conducted to collect data on 218 880 pregnant women who were hospitalized in 22 hospitals which were under a monitoring program,in Hebei province,from January 1,2013 to December 31,2016.Data regarding epidemiological characteristics as time distribution,population distribution and related risk factors of placental abruption were gathered and analyzed.Results In this cohort study,218 880 women were included,with 669 (0.31％) of the pregnant women having PA.The overall prevalence rates were higher in the South than in the north parts of the area and higher in more developed regional economic centers.The average age of women having the episode was (27.87 ± 4.50) years and presented “J” distribution on the prevalence of maternal age.Results from the multivariate regression analysis showed that the following factors were independently at risk for placental abruption:pregnancy the including hypertension (OR=1.65,95％CI:1.09-2.50),mild preeclampsia (OR=3.65,95％CI:2.40-5.56),severe preeclampsia (OR=4.72,95％CI:3.86-5.76) and anemia (OR=2.41,95％CI:2.05-2.83) which were all increased in pregnant women with PA compared with the normal female population without placental abruption.Conclusions Placental abruption seemed to be associated with a moderate increasing risk of age,and was seen higher in those population older than 35 or younger than 20 year-olds.It was suggested that appropriate inoculation programs should be taken in different regions,especially on high-risk groups.Health education on related disease was of great significance for improving the prenatal outcome.