产妇高龄对新生儿出生缺陷及生后并发症的影响

Effect of advanced maternal age on birth defects and postnatal complications of neonates

摘要:

目的 探讨产妇高龄对新生儿出生缺陷及生后并发症的影响。方法 2014年1月至2015年12月在云南省第一人民医院入住的1109例新生儿中，选取年龄≥35岁的高龄产妇所产新生儿536例作为高龄组，随机选取同期分娩的年龄 < 35岁的适龄产妇所产新生儿573例作为适龄组。比较两组产妇妊娠期合并症、胎儿宫内窘迫及新生儿出生缺陷、生后并发症等情况；通过单因素logistic回归分析产妇高龄对新生儿围产期合并症的影响。结果 高龄组产妇剖宫产率、多胎次、妊娠期糖尿病、妊高症、试管婴儿、胎儿宫内窘迫发生率均显著高于适龄组，差异均有统计学意义 （P < 0.01）；高龄组新生儿唇腭裂发生率高于适龄组，骨骼畸形率低于适龄组 （P < 0.05）。高龄是造成胎儿宫内窘迫 （OR=2.27；95%CI：1.33~3.88；P=0.003）、新生儿复苏 （OR=1.66；95%CI：1.19~2.31；P=0.003）和颅内出血 （OR=2.70；95%CI：1.21~6.04；P=0.02）的危险因素。结论 高龄产妇妊娠期合并症发生率高于适龄产妇，其所产新生儿唇腭裂发生率高于适龄产妇；产妇高龄会增加胎儿宫内窘迫、新生儿复苏抢救和颅内出血的风险。

Abstract:

Objective To investigate the effect of advanced maternal age on birth defects and postnatal complications of neonates. Methods Among the 1 109 neonates who were born at The First People's Hospital of Yunnan Province between January 2014 and December 2015, 536 neonates whose mothers were aged≥35 years were enrolled as advanced age group and 573 neonates whose mothers were aged <35 years were enrolled as appropriateage group. The incidences of the comorbidities in pregnancy, fetal intrauterine distress, neonatal birth defects, and postnatal complications were compared between the two groups. A univariate logistic regression analysis was performed to analyze the effect of advanced maternal age on neonatal comorbidities during perinatal period. Results Compared with the appropriate-age group, the advanced age group had significantly higher rate of caesarean section and incidence rates of multiple birth, gestational diabetes, pregnancy-induced hypertension, in vitro fertilization, and fetal intrauterine distress (P < 0.01). The neonates in the advanced age group had a significantly higher incidence rate of cleft lip and palate and a significantly lower rate of skeletal dysplasia than in the appropriate-age group (P < 0.05). Advanced maternal age was the risk factor for fetal intrauterine distress (OR=2.27, 95%CI:1.33-3.88, P=0.003), neonatal resuscitation (OR=1.66, 95%CI:1.19-2.31, P=0.003), and intracranial hemorrhage (OR=2.70, 95%CI:1.21-6.04, P=0.02). Conclusions The women of maternal advanced age have higher incidence rates of pregnancy comorbidities than those of appropriate age, and the neonates born to the mothers of advanced maternal age have a higher incidence rate of cleft lip and palate. Advanced maternal age may increase the risks of fetal intrauterine distress, neonatal resuscitation, and intracranial hemorrhage.