| Objective:At present,the pathogenesis of hyperemesis gravidarum and the relationship between hyperemesis gravidarum and pregnancy outcome are still unclear.This study will analyze the possible risk factors of hyperemesis gravidarum and the possible adverse effects of hyperemesis gravidarum on maternal and infant outcomes,so as to prevent the occurrence of risk factors and improve maternal and infant pregnancy outcome.Methods:For retrospective analysis,we collected patients diagnosed with hyperemesis gravidarum in the hospital from January 2015 to January2019,through comparing inclusion and exclusion criteria,eventually collecting 116 cases as observation group.At the same time we selected randomly 116 cases as control group from the hospital outpatient who received physical checks and delivery of pregnancy and does not been diagnosed with hyperemesis gravidarum in the same period.By collecting the general information of the two groups of pregnant women,laboratory indicators of early pregnancy,maternal and infant complications and delivery outcomes,and comparing the clinical data of the two groups of pregnant women and neonates,the correlation factors of HG and the relationship between them and pregnancy outcomes were analyzed.Results1.General information: there were a total of 39310 people between January 2015 and January 2019 in our hospital,the number of patients diagnosed with hyperemesis gravidarum was 121,and incidence of hyperemesis gravidarum was about 0.31%.Patients’ age in observation group was between 18 and 41 years old,and their average age were28.22±4.31 years old;the gestational age of symptoms of nausea and vomiting appeared at 4.28 ~13.28 weeks,and their average gestational age were 6.85±1.53 weeks;the hospitalization days was between 2 and47 days,and average hospitalization days were 6.97±6.28 days;times of hospitalization was between 1 to 5,and average times were 1.5±0.84.Compared with the control group,the observation group had a lower pre-pregnancy BMI and less weight gain during pregnancy,and the comparison between the two groups was statistically significant(P<0.05).The observation group had a higher incidence of dysmenorrhea and vaginal bleeding during pregnancy;besides,the proportion of previous HG in its family members was higher than that in the control group,and there was a statistical difference between the two groups(P<0.05).There was no statistical difference between the two groups in age,pregnancy,birth,education,marital status,smoking,and so on(P>0.05).2.Conditions of pregnant and parturient women: compared with the control group,the level of TSH in the observation group decreased and the level of FT4 increased,showing significant statistical difference(P<0.01).The levels of ALT,AST and total bilirubin in the observation group increased,and there was a statistical difference between the two groups(P<0.05).Neutrophil count and NLR count increased in the observation group,and lymphocyte count decreased in the observationgroup,and there was a statistical difference between the two groups(P<0.05).In the observation group,the levels of K+,Na+ and Cldecreased,and the level of urinary ketone body increased,and there was a significantly statistical difference between the two groups(P<0.01).Compared with the control group,the incidence of HDP and pregnancy anemia was higher in the observation group,and there was a statistical difference between the two groups(P<0.05).There was no significant difference between the two groups in the incidence of PROM,GDM,PPH,ICP,placental abruption,placenta previa,abnormal sheep water volume and other diseases(P>0.05).No venous thromboembolism occurred during pregnancy in either group.3.Newborns: compared with control group,the incidence of low birth weight and SGA increased in the observation group,and there was a statistical difference between the two groups(P<0.05).The neonatal birth weight of observation group(3118.49±527g)was lower than the control group(3339.83 ± 516.71 g),and there was a significant statistical difference between the two groups(P<0.01).Neonatal gestational age in the observation group(38.64±1.54 weeks)is slightly lower than the control group(39.02 ± 1.64 weeks),there was no significant difference between the two groups(P > 0.05).There was no significant difference between the two groups in the incidence of neonatal intracranial hemorrhage,neonatal asphyxia,RDS,premature delivery(P>0.05).There were no statistically significant differences between the two groups in gender,neonatal transfer rate,1-minute and5-minute Agpar scores(P > 0.05).There was no oaf in the two groups.4.Multivariate analysis of influencing factors of HG: logistic regression analysis showed that risk factors for HG were low pre-pregnancy weight,dysphoria,and history of vaginal bleeding duringpregnancy.The chance of HG in those women with low birth weight before pregnancy was 3.579 times than those with non low birth weight(OR = 3.579,95% CI: 0.122 0.642,P = 0.003).And the chance of HG in those female with dysmenorrhea was 1.911 times than those don’t pain(OR = 1.911,95% CI: 1.107 3.297,P = 0.02).And the risk of HG in those women with a history of vaginal bleeding during pregnancy was2.494 times than that in patients with no history of vaginal bleeding during pregnancy(OR = 2.494,95% CI:1.076-5.783,P=0.033).Conclusions:1.The occurrence and development of hyperemesis gravidarum was related to the low pre-pregnancy weight,dysmenorrhea,vaginal bleeding and other factors,and it was the result of multiple factors.2.Hyperemesis gravidarum is associated with abnormal thyroid and liver function,electrolyte disorders,and increased the risk of HDP and anemia during pregnancy.3.Hyperemesis gravidarum increased the risk of low birth weight and small for gestation age;and the fetal birth weight was relatively small. |
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