| 朱微波,赵汉青.基于限制性立方样条回归探索妊娠间隔与分娩方式间的关系研究[J].安徽医药,待发表. |
| 基于限制性立方样条回归探索妊娠间隔与分娩方式间的关系研究 |
|
| 投稿时间：2025-03-25 录用日期：2025-05-08 |
| DOI： |
| 中文关键词: 剖宫产 妊娠间隔 妊娠结局 限制性立方样条回归 |
| 英文关键词: |
| 基金项目:国自然青年科学(项目编号:82004503) |
|
| 摘要点击次数: 84 |
| 全文下载次数: 0 |
| 中文摘要: |
| 目的: 探索降低经产妇剖宫产率发生的最佳妊娠间隔。方法: 回顾性收集2015年6月至2024年5月期间在首都医科大学附属北京同仁医院门头沟医院建档并分娩的2060名经产妇的年龄、前一次和本次分娩方式、孕前体质指数(body mass index,BMI)和妊娠间隔等临床基本资料。首先采用差异性分析和多因素Logistic回归探讨校正混杂因素后妊娠间隔与分娩方式的相关性,然后采用限制性立方样条回归进一步探讨二者的非线性关系。结果:多因素logistic回归显示:校正年龄、前一次分娩方式、孕次、产次、孕前BMI和出生体质量等混杂因素后,与妊娠间隔<18月组比较,18~59月组是分娩方式为剖宫产的保护因素(OR=0.690,95%CI:0.494~0.963),而≥60月组是分娩方式为剖宫产的危险因素(OR=1.406,95%CI:1.014~1.949)。限制性立方样条回归分析结果显示,校正混杂因素后,全年龄组经产妇妊娠间隔在22.48~47.08月时,剖宫产发生风险降低,妊娠间隔为34.44月时,风险最低；非高龄组经产妇妊娠间隔在15.64~47.76月时,剖宫产的风险降低,妊娠间隔为32.39月时,风险最低；高龄组经产妇妊娠间隔在23.16~50.50月时,剖宫产发生的风险降低, 妊娠间隔为35.80月,风险最低。结论:对于降低经产妇剖宫产率,全年龄组妊娠间隔控制在22.48~47.08月为宜,34.44月左右最佳,其中非高龄妊娠间隔控制在23.84~51.18月为宜,36.49月左右最佳；高龄妊娠间隔控制在23.16~50.50月为宜,35.80月左右最佳。 |
| 英文摘要: |
| Objective: Exploring the optimal interpregnancy interval to reduce the cesarean section rate in primiparous women.Methods: Retrospectively collected from June 2015 to May 2024 in Beijing Tongren Hospital Mentougou District ,Capital Medical University 2060 cases of primiparous women registered and delivered age, previous and current delivery mode, BMI and other clinical basic data and interpregnancy interval. First, the correlation between interpregnancy interval and delivery mode was explored by differential analysis and multivariate logistic regression after adjusting for confounding factors, and then the nonlinear relationship between the two was further explored by restricted cubic spline regression.Results: Multivariate logistic regression showed that after adjusting for age, previous delivery mode, number of pregnancies, number of births, BMI, birth weight and other confounding factors, compared with interpregnancy interval of <18 months, the 18 - to 59 - month group was a protective factor for cesarean section delivery (OR=0.690, 95%CI: 0.494-0.963), while the group of ≥60 months was a risk factor for cesarean section delivery (OR=1.406, 95% CI: 1.014-1.949). The results of the restricted cubic spline regression analysis showed that after adjusting for confounding factors, for the entire age group of primiparous women, the risk of cesarean section decreased when the interpregnancy interval was 22.48 to 47.08 months, and the risk was lowest at 34.44 months. For the non - advanced - age group of primiparous women, the risk of cesarean section decreased when the interpregnancy interval was 15.64 to 47.76 months, and the risk was lowest at 32.39 months; for the advanced - age group of primiparous women, the risk of cesarean section decreased when the interpregnancy interval was 23.16 to 50.50 months, and the risk was lowest at 35.80 months. Conclusion: To reduce the incidence of cesarean section, the interpregnancy interval for the entire age group of primiparous women should be controlled at 22.48 to 47.08 months, with around 34.44 months being the best. For the non - elderly primiparae, it is appropriate to control the interpregnancy interval at 23.84 - 51.18 months, and the optimal time is around 36.49 months. For elderly primiparae, it is appropriate to control the interpregnancy interval at 23.16 - 50.50 months, and the optimal time is around 35.80 months. |
|
查看/发表评论 下载PDF阅读器 |
| 关闭 |
|
|
|
