| ObjectiveThrough retrospective studies,clinical data on perinatal outcomes in people with full-term pregnancy and late-term pregnancy were collected,and the effects of full-term pregnancy and late term pregnancy on maternal and infant perinatal outcomes were evaluated,so as to explore the appropriate timing of delivery,avoid adverse perinatal outcomes,and ensure the life safety of mothers and infants.Subjects and methodsA total of 1271 pregnant women who were hospitalized in the obstetrics department of the Second Affiliated Hospital of Nanchang University from January2019 to December 2021 and delivered uncomplicated gestation from 39 0/7 weeks to41 6/7weeks of pregnancy were selected as the study subjects,including 580 cases in group A(the 39 0/7 to 39 6/7 weeks gestation group)and 478 cases in group B(the 400/7 to 40 6/7 weeks gestation group).There were 213 cases in group C(the 41 0/7 to41 6/7 weeks pregnant group).By reviewing the maternal medical records and neonatal delivery records,including the age of the pregnant woman,the pregnancy time,the birth,the admission cervical Bishop score,the mode of delivery(spontaneous delivery,intermediate cesarean section),meconium contamination,total duration of labor,the amount of postpartum 2h blood loss during vaginal delivery,indications for cesarean section,neonatal weight,neonatal Apgar score and other data were statistically analyzed.Results1.General data: There were no significant differences in maternal age,pregnancy and parity between the groups,and there were significant differences in admission cervical Bishop scores(p<0.05).As the gestational age of delivery increases,maternal age decreases slightly,and the admission cervical Bishop score gradually decreases.2.Perinatal outcomes: there were statistically significant differences between the three groups in mode of delivery,total duration of labour,intrapartum 2-hour postpartum bleeding,meconium contamination,neonatal birth weight(p<0.05).The proportion of multiparous women decreased roughly with the increasing gestational age of delivery(40% vs.39.1% vs.31.9%).The risk of transit caesarean section increased gradually with the extension of gestational age(6.9% vs.10.9% vs.23.0%),with a significant difference(p<0.05).Comparing the mode of delivery with the same delivery period within the group,it was found that the proportion of primary women transitioning to caesarean section increased with the extension of the gestational age(11.2% vs.15.8% vs.28.3%),and there was a statistically significant difference in the mode of delivery of nulliparous women in all three groups(p<0.05).Total duration of labour increased gradually with the extension of gestational age(417.00±229.71 min vs.421.16±212.57 min vs.490.30 ±204.36min),compared with the late-term pregnancy group,the full-term pregnancy group was significantly different(p<0.05).The amount of intrapartum and 2 hours postpartum blood loss gradually increased with the extension of gestational age(240.68±95.19 m L vs.257.91±126.63 m L vs.274.00±168.78 m L),Group A compared to Group B and Group C,there was a significant difference in intrapartum 2h postpartum blood loss(p<0.05).The apnea rate of apnea score at 1 minute and 5 minutes of birth was basically unchanged with gestational age(2.2% vs.2.3% vs.1.4%;0.2% vs.0.4% vs.0.0%),and the difference was not statistically significant(p>0.05).Compared with the 41 0/7 to 41 6/7 weeks in full-term pregnancy,the rate of meconium contamination gradually increased with the extension of gestational age(23.3% vs.31.8%),and the difference was statistically significant(p<0.05).The proportion of women with meconium-stained amniotic fluid women who had meconium-stained amniotic fluid had an increase in terms of the length of gestational age(9.6% vs.16.4% vs.33.3%),and compared with group C,there was a significant difference in the mode of delivery between women with meconium contamination in groups A and B(p<0.05).Newborn birth weight increased with increasing gestational age(3.30±0.37 kg vs.3.41±0.36 kg vs.3.51±0.38kg),there were significant differences between groups(p<0.05);There were statistically significant differences in birth weight among neonatal birth modes in group B(p<0.05).The proportion of small full-term infants decreased gradually with the extension of gestational age(1.4% vs.0.2% vs.0.0%),and the proportion of macrosomia increased gradually with the increase of gestational age(3.1% vs.5.2%vs.8.5%),and there were significant differences in small full-term infants and macrosomia between different gestational weeks(p<0.05).The episiotomy rate of women increased with the extension of gestational age(37.4% vs.41.1% vs.49.4%),and the difference in episiotomy rate was statistically significant between spontaneous delivery in group A and spontaneous delivery in group C(p<0.05).The rate of assisted delivery with fetal head aspiration increased gradually with the extension of gestational age(5.0% vs.8.6% vs.9.9%),and there was no significant difference in assisted delivery rate between groups(p>0.05).The indications for transfer to caesarean section in different gestational groups were prolonged latent period,arrest of active period,prolonged second stage of labor,fetal distress,relative head-pelvic disproportion,and placental abruption,all of which were not statistically significant(p>0.05).3.Results of multivariate regression analysis,comparing group A with group C,and the risk of intermediate cesarean section increased with the increase of gestational age(OR: 0.325,95% CI: 0.196～0.541,p<0.001);Increased neonatal birth weight(OR: 0.202,95% CI: 0.125～0.327,p<0.001);Total prolongation of labour(OR: 0.999,95% CI: 0.998～1.000,p=0.006);The amount of bleeding increased at the time and 2hours after delivery(OR: 0.998,95% CI: 0.997～1.000,p=0.009).Group B was compared with Group C,the risk of intermediate caesarean section increased with the increase of gestational age(OR: 0.493,95% CI: 0.309～0.786,p=0.003);Increased neonatal birth weight(OR: 0.575,95% CI: 0.362～0.913,p=0.019);Total labour was prolonged(OR: 0.999,95% CI: 0.998～1.000,p=0.003).Conclusion1.In the group of full-term pregnancies,the rates of cesarean section and meconium-stained amniotic fluid,as well as the birth weight of newborns,were significantly higher in the 40 0/7 to 40 6/7 weeks gestation group than in the group of39 0/7 to 39 6/7weeks of pregnancy;the differences were statistically significant.However,there were no statistical differences in the length of the total stage of labor,Apgar score of newborns,episiotomy rate,ventouse rate,and indication of cesarean section.2.Compared with the full-term pregnancy group at the 40 0/7 to 40 6/7 weeks,the conversion rate to cesarean section increased,the total duration of labor increased,and the birth weight of newborns increased in the late-term pregnancy group at the 410/7 to 41 6/7 weeks.The differences were statistically significant;There were no statistically significant differences in the amount of bleeding during the 2-hour postpartum period,Apgar score at birth,meconium contamination rate,perineal lateral section rate and vaginal surgical delivery rate,as well as indications for conversion to cesarean section;3.Compared with the full-term pregnancy group,pregnant women with meconium contamination had a higher rate of conversion to cesarean section in the late-term pregnancy group,and the difference was statistically significant. |
PDF Full Text Request