The Influencing Factors Of Adverse Pregnancy Outcome

ObjectiveThis study was conducted to evaluate the basic condition and influence factors of the five kinds of adverse pregnancy outcomes, which is macrosomia, low birth weight,premature birth, stillbirth and birth defect. We aim to reduce the incidence of adverse pregnancy outcomes and provide the basis evidence for future studies of eugenics.MethodsThe electronic medical records of 27709 pregnant women during pregnancy, were collected from database of the Maternal and Child Health Institute, through the data sorting, analysis of the influence of basic situation of pregnant women, previous pregnancy history and pregnancy on pregnancy outcome. Using statistical analysis software SPPS18.0, combined with the methods of health statistics, a general description, single factor Logistic regression, multivariate Logistic regression analysis of the relationship between various factors and several main adverse pregnancy outcomes were analyzed.Results1. The total incidence rate of adverse pregnancy outcomes was 15.4%, the highest incidence rate was 9.37% for macrosomia, followed by premature, the incidence rate was 3.55%. The incidence rate of macrosomia is higher than the national average level,the incidence of other adverse pregnancy outcome is lower than the national average level.2. Risk factors of macrosomia are: OR for polyhydramnios is 2.06(95%CI:1.55,2.73), 2.33(95%CI: 1.35,4.02) for fetal malformation production history,1.47(95%CI: 1.18,1.82) for GDM, 1.35(95%CI: 1.12,1.63) for aged older than 35 years,1.28(95%CI: 1.01,1.62) for parity is over 2, 1.25(95%CI: 1.08,1.44) for pregnant timesover 2; 0.71(95%CI: 0.55,0.92) for less than aged 20 years, 0.76(95%CI: 0.62,0.92)for menstrual pain, 0.85(95%CI: 0.76,0.95) for prenatal examination 1~4 times and0.63(95%CI: 0.48,0.82) for abnormal fetal position.3.Risk factors of low birth weight are :OR for A history of preterm birth is5.12(95%CI: 1.97,13.32), 5.49(95%CI: 3.45,8.73) for pregnancy induced hypertension,3.95(95%CI: 3.03,5.14) for abnormal fetal position, 3.68(95%CI: 2.99,4.52)for no prenatal examination, 2.41(95%CI: 1.97,2.94) for prenatal examination 1 ~ 4 times,1.58(95%CI: 1.17,2.13) for less than aged 20 years, 1.30(95%CI: 1.04,1.63)for HBs Ag carrying. In addition, pregnant women with aged 25~30 years,compared to pregnant women age 20~25 years,can reduce the risk of low birth weight.4. The risk factors of premature delivery are: OR for History of premature delivery is 7.08(95%CI: 3.59,13.95), 2.91(95%CI: 2.30,3.69) for abnormal fetal position,2.82(95%CI: 2.37,3.35)for no prenatal examination, 2.05(95%CI: 1.74,2.41) for prenatal examination 1~4 times, 2.53(95%CI: 1.34,4.78)for the history of ectopic pregnancy, 2.13(95%CI: 1.27,3.58) for pregnancy induced hypertension, 1.84(95%CI:1.46,2.31) for early pregnancy vaginal bleeding, 1.54(95%CI: 1.17,2.02) for aged older than 35 years, 1.55(95%CI: 1.19,2.02) for less than aged 20 years, 1.43(95%CI:1.20,1.71) for HBs Ag carrying.5. Risk factors for stillbirth are: OR for abnormal fetal position pregnancy is5.99(95%CI: 3.46,10.37), 6.35(95%CI: 3.90,10.34) for no prenatal examination,3.32(95%CI: 1.78,6.18) for prenatal examination 1~4 times, 3.21(95%CI: 1.62,6.36) for menstrual pain, 0.49(95%CI: 0.28,0.86) for having pregnancy history.6. Risk factors of birth defects is malformation fetus production history and abnormal fetal position, the ORs were 8.12(95%CI: 1.93,34.18), 2.36(95%CI:1.02,5.43) respectively.ConclusionIn the study of adverse pregnancy outcomes, the highest incidence rate was macrosomia, higher than the national level, other adverse pregnancy outcomes are less than the national level. The adverse pregnancy outcomes are different, its related factors are also different. Age, abnormal fetal position, fewer prenatal examination times effectson pregnancy outcomes were various. To establish special record for pregnant women risk factors, strengthen the prenatal care and prenatal monitoring, prevention and control important risk factors and improve maternal pregnancy care knowledge have important Influence to ensure maternal and fetal health.