| ObjectivesThrough the investigation of the general conditions of pregnant women in Tianjin,the pre-pregnancy and pregnancy lifestyles,pregnancy complications and complications,the medication use during pregnancy,and pregnancy outcomes,the relevant factors of adverse pregnancy outcomes were analyzed to clarify the adverse pregnancy outcomes.Relevant influencing factors,explore the correlation between medications during pregnancy,including traditional Chinese medicine and western medicine,and adverse pregnancy outcomes,and provide evidence-based evidence for the rational use of medications during pregnancy.MethodsThis study is a cross-sectional study,using a cluster random sampling method to divide the16 districts of Tianjin into two areas:the central city and the suburbs according to administrative divisions.The subordinate municipal districts are numbered from 1 to n respectively,and the lottery method is used from 1 to n.4-5 municipal districts were selected from each of the two regions,and a cross-sectional survey was conducted on women who gave birth from July 2020 to November 2020 in obstetrics departments of 1-2 hospitals in the selected municipal districts.The unified"Medications during Pregnancy Survey Form"was used to conduct a questionnaire survey on the parturients who met the standards,the questionnaire information was entered into Microsoft Excel,and the data was statistically analyzed through SPSS 22.0.Result1.General situation:A total of 1912 women were asked to participate in the study and1798(94.04%)of them provided complete information,of which,916 cases were from central urban area,while 882 cases were from suburbs.The age of the 1798 women ranged from 19to 45,with a mean age of 30.4±4.1 years.42(2.3%)cases used ART.10(0.6%)cases were twins pregnancies.There were 193(10.7%)women had anemia,6(0.3%)women had cardio disease,88(4.9%)women had hypertension,304(16.9%)women had GDM,94(5.2%)women had gynecological diseases,95(5.3%)women had thyroid disease,16(0.9%)women had hepatitis B,6(0.3%)women had STD,and 4(0.2%)women had psychiatric/neurological diseases2.Medication use during pregnancy:The prevalence of medications use during pregnancy was 31.2%.24.5%of the participants used western medicine.9.6%of the participants used TCM.And 5.3%of the participants used both western medicine and TCM.Progestin is the most frequently used western medicine during pregnancy.Among TCM users,most women used proprietary Chinese medicine to prevent abortion and treat cough and cold.3.Pregnancy outcome:743(41.3%)cases had vaginal delivery,and 1055(58.7%)had caesarean section.219 cases had adverse pregnancy outcomes,with a prevalence of 12.18%.117(6.48%)cases had fetal macrosomia.59(3.27%)cases had premature birth.43(2.38%)cases had low birth weigh.15(0.83%)cases had neonatal deformity.12(0.67%)cases had neonatal asphyxia.2(0.11%)cases were stillborn.1(0.06%)case was neonatal death.4.Relationship between medicine use during pregnancy and adverse pregnancy outcomes:The results of univariate analysis showed that adverse pregnancy outcomes(13.19%VS11.72%),macrosomia(6.95%VS6.31%),premature delivery(3.74%VS3.07%),and low birth weight occurred in pregnant women with and without drugs.(2.67%VS2.26%),neonatal asphyxia(0.53%VS0.73%),stillbirth(0.36%VS0),neonatal death(0VS0.08%),neonatal deformity(0.53%VS0.97%)There was no statistically significant difference in risk(P>0.05);adverse pregnancy outcomes(8.67%VS12.48%),macrosomia(5.78%VS6.55%),premature delivery(1.16%VS3)occurred in pregnant women with and without traditional Chinese medicine.49%),low birth weight(0.58%VS2.57%),neonatal asphyxia(0VS0.73%),stillbirth(0.58%VS0.06%),neonatal death(0VS0.06%),neonatal deformity(0.58%VS0.86%)there was no statistically significant difference in the risk(P>0.05);adverse pregnancy outcomes(13.84%VS11.57%)and macrosomia(7.23%VS6.24%),premature delivery(3.93%VS3.04%),low birth weight(3.10%VS2.13%),neonatal asphyxia(0.62%VS0.68%),stillbirth(0.41%VS0),neonatal death(0VS0.08%),the risk of neonatal deformity(0.41%VS0.99%)was not statistically different(P>0.05).5.Influence factors of adverse pregnancy outcome:The results of univariate analysis showed that BMI(X2=18.428,P=0.000),ART(X2=7.892,P=0.005),twin pregnancy(X2=0.109,P=0.039),heart disease(X2=4.893,P=0.027),hypertension in pregnancy(X2=21.215,P=0.000),GMD(X2=9.442,P=0.002)are risk factors for adverse pregnancy outcomes;BMI(X2=28.542,P=0.000),GDM(X2=8.189,P=0.004)is a risk factor for the occurrence of macrosomia;BMI(X2=9.633,P=0.008),history of bad pregnancy(X2=4.587,P=0.032),history of cesarean section(X2=8.025,P=0.005),twin pregnancy(X2=31.877,P=0.000),heart disease(X2=8.947,P=0.003),hypertension in pregnancy(X2=19.044,P=0.000)are risk factors for preterm birth;ART(X2=26.063,P=0.000),twin pregnancy(X2=97.639,P=0.000),hypertension in pregnancy(X2=31.908,P=0.000)are risk factors for low birth weight.There is no obvious correlation between general conditions,maternity status,lifestyle,pregnancy comorbidities and neonatal malformations and neonatal asphyxia.The statistically significant factors in the univariate analysis were incorporated into the covariates of the multivariate logistics regression analysis.The results showed that overweight(BMI24-27.9kg/m~2)and obesity(≥28kg/m~2)mothers were more likely to have adverse pregnancy outcomes than BMI Normal(BMI<24kg/m~2)women are 0.561 times and 0.776times higher,twin pregnancy,heart disease,hypertension in pregnancy,and GDM women are at risk of adverse pregnancy outcomes than singleton pregnancy,without heart disease,and without heart disease.Hypertension during pregnancy and women without GDM are 9.199times,5.602 times,1.522 times,and 0.515 times higher;overweight and obese women are0.827 times and 2.232 times higher than those with normal BMI,and women with GDM are higher than those without GDM.The risk of giant babies is 0.572 times higher;compared with women without a history of cesarean section,singleton pregnancy,without heart disease,and without hypertension in pregnancy,women with a history of cesarean section,twin pregnancy,combined heart disease,pregnancy The risk of preterm birth in women with hypertensive disease is 1.172 times,24.251 times,11.095 times,and 3.563 times higher.Compared with singleton pregnancy and women with hypertension in pregnancy,low birth weight occurs in twin pregnancy and women with hypertension in pregnancy.The risk is27.435 times and 5.588 times higher.Conclusion1.The pregnancy rate of pregnant women in Tianjin is 31.2%,of which the rate of western medicine is 24.5%,the rate of traditional Chinese medicine is 9.6%,and the rate of pregnant women who use traditional Chinese medicine and western medicine is 5.3%.Progesterone is the western medicine with the highest use rate during pregnancy,with a drug use rate of13.7%.Traditional Chinese medicine mainly uses proprietary Chinese medicines,which are mainly used to prevent fetuses and treat upper respiratory tract infections.2.Pregnancy medications(including traditional Chinese medicines that are mainly used to invigorate the kidney and relieve the surface,and western medicines based on progesterone)and adverse pregnancy outcomes(including huge babies,premature birth,low birth weight,neonatal asphyxia,stillbirth,neonatal death,Neonatal malformations)have no obvious correlation.However,due to the small sample size in this study,it may have a certain impact on the results of the study,so long-term monitoring of medications during pregnancy is needed to reduce the risk of adverse pregnancy outcomes.3.Obesity,twin pregnancy,heart disease,hypertension in pregnancy,and GDM are independent risk factors for adverse pregnancy outcomes.Among them,obesity and GDM are closely related to the occurrence of macrosomia,cesarean section history,twin pregnancy,heart Diseases and hypertension in pregnancy are closely related to premature birth;twin pregnancy and hypertension in pregnancy are closely related to low birth weight.Therefore,attention should be paid to weight management during pregnancy,to control pregnancy complications such as hypertension and GDM during pregnancy,and to reduce twin pregnancies in order to reduce the risk of adverse pregnancy outcomes. |
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