Analysis Of Clinical Data Of Pregnant Women Of Different Ages

Objective:1.To study the clinical characteristics of pregnant women at different ages;2.To compare the differences in general conditions,pregnancy complications,maternal and child outcomes,and delivery methods among women in the appropriate age group,women in the advanced age group,and women in the super-age group;3.To study the relationship between maternal age increase and pregnancy complications,the occurrence of adverse maternal and child outcomes,and the choice of delivery methods.Methods:The clinical data of 8460 parturients with singleton delivery and gestational age ≥26 weeks in the first hospital of Shanxi Medical University from September 1,2017 to August 31,2020 were retrospectively analyzed.According to the age,they were divided into three groups: the right age group(20-34 years old),the advanced-age group(35-39 years old),and the super-advanced age group(≥ 40 years old).Statistical analysis was conducted by Fisher exact probability method and P < 0.05 was considered as statistical difference.The p value was adjusted by Bonfreund method.Results:1.A total of 8460 maternities were enrolled in this study,Among them,there were6891 maternities(81.50%)in the age-appropriate group,1289 maternity(15.20%)in the,and 280 maternities(3.30%)in the over-advanced age group.The average age of the subjects was 30.58 years old.2.The general situation of the three groups of maternity:Compared with the three groups of women in terms of the composition of conception methods,regular obstetrics,parity,obesity in the third trimester,incidence of complicated pregnancy and childbirth,and incidence of previous cesarean section/hysterectomy,it is statistically significant(P< 0.05).There were statistically significant differences in the rates of reduced natural conception,higher proportion of multiparous women,higher incidence of obesity,higher incidence of combined adverse pregnancy history,and higher incidence of a scarred uterus in the advanced-age group compared with the age-appropriate group.Compared with the age-appropriate group,the over-advanced age group had a lower rate of regular birth examination,higher proportion of multiparous women,higher incidence of combined adverse pregnancy history and higher incidence of a scarred uterus with statistical difference.Compared with the advanced-age group,the rate of regular birth examiners was lower and the percentage of multiparous women was higher in the over-advanced age group,which was statistically different.3.The maternal pregnancy complications of three groups:The incidences of GDM/PGDM,hypertensive disorders of pregnancy,placenta previa,placenta accreta,incomplete uterine rupture,and postpartum hemorrhage among the three groups were statistically different(P < 0.05).The incidence of GDM/PGDM,hypertensive disorders of pregnancy,placenta previa,placenta accreta,incomplete uterine rupture,postpartum hemorrhage in the advanced-age group was significantly higher and statistically significantly different compared with the age-appropriate group.Compared with the age-appropriate group,the incidence of GDM/PGDM,hypertensive disorders of pregnancy,and placenta accreta in the over-advanced age group was significantly higher and statistically different.The incidence of GDM/PGDM,gestational hypertensive disorders was elevated in the overadvanced age group compared to the advanced-age group with statistically significant differences.4.The maternal and child outcomes the of three groups : There were statistically significant differences in the incidence of maternal transfer to the ICU,stillbirth,preterm delivery,and neonatal asphyxia among the three groups.Compared with the age-appropriate group,the incidence of neonatal asphyxia in the advanced-age group was significantly higher and statistically different.Compared with the age-appropriate group,the rate of maternal transfer to the ICU,stillbirth,preterm delivery was significantly higher and statistically different in the over-advanced group.The incidence of stillbirth was elevated in the over-advanced age group compared to the advanced-age group with statistical difference.5.The maternal delivery methods of three groups: There were statistically significant differences in the mode of delivery among the three groups,with a decrease in the rate of spontaneous delivery,vaginal midwifery and an increase in the rate of cesarean section in both the advanced and over-advanced age groups compared with the age-appropriate group.Conclusion:1.The rate of assisted reproductive conception,the proportion of multiparous women,irregular deliveries,the incidence of obesity,the incidence of combined adverse pregnancy history,and the proportion of scarred uterus were higher among women of advanced-age group than among women of appropriate-age group.The proportion of multiparous women was further increased among women of over-advanced age groups compared with those of advanced-age group.2.The incidences of pregnancy comorbidities / complications and adverse pregnancy outcomes were higher among women of advanced and over-advanced age groups than among women of appropriate age group,and the incidences of some pregnancy comorbidities were higher among women of over-advanced age group than among women of advanced age group,which further increased.3.The rate of vaginal birth was lower,while the rate of cesarean section was higher,in both advanced and over-advanced age groups than in age-appropriate group parturients.4.Strengthen maternal health care and preaching at advanced ages,and actively intervene in their pregnancy comorbidities and complications to avoid adverse pregnancy outcomes.