子宫腺肌症对妊娠并发症及妊娠结局的影响

Effects of adenomyosis on pregnancy outcomes and pregnancy complications

关键词:  子宫腺肌症  辅助生殖技术  妊娠并发症  超声

Key words:  uterine adenomyosis  assisted reproductive technology  pregnancy complications  ultrasound

摘要:

目的探讨子宫腺肌症对妊娠并发症及妊娠结局的影响。方法回顾性分析病史资料完整孕妇的妊娠结局及并发症，对比正常孕妇与伴有子宫腺肌症孕妇的妊娠结局及并发症情况。结果纳入本研究孕妇3 300名，其中患有子宫腺肌症241名，3 059名无子宫腺肌症孕妇作为对照组。子宫腺肌症组孕妇妊娠并发症发病率明显高于正常对照组，包括子痫前期（7.0% vs 2.5%，P＜0.001）、妊娠期糖尿病（14.5% vs 10.4%，P＜0.05）、宫颈机能不全（4.9% vs 0.8%，P＜0.001）、前置胎盘（2.9% vs 0.5%，P＜0.001）、流产（14.5% vs 1.8%，P＜0.001）、早产（＜37周，12.0% vs 5.0%，P＜0.001）、低体重儿（7.9% vs 3.6%，P＜0.001）。正常对照组胎膜早破发生率高于子宫腺肌症组（20.5% vs 12.8%，P＜0.05）。子宫腺肌症自然受孕亚组胎膜早破发生率高于辅助生殖亚组（P<0.05），而自然受孕亚组和辅助生殖亚组的早产、流产及妊娠并发症发生率差异无统计学意义(P>0.05)。结论子宫腺肌症会增加流产、早产的发生率，也会增加孕妇妊娠并发症的发病率，而受孕方式对流产、早产及妊娠并发症的发病率无明显影响。

Abstract:

ObjectiveTo investigate the effect of uterine adenomyosis on pregnancy complications and pregnancy outcomes. MethodsThe medical records of 3 300 singleton pregnant women in Shanghai First Maternity and Infant Hospital were retrospectively reviewed, there were 241 cases of adenomyosis（adenomyosis group), and 3 059 cases without adenomyosis（normal control group). The association of adenomyosis and pregnancy complications and pregnancy outcomes was analyzed. ResultsThe incidence of pregnancy complications in adenomyosis group was significantly higher than that in normal control group, including preeclampsia（7.0% vs 2.5%，P＜0.001), gestational diabetes mellitus（14.5% vs 10.4%, P<0.05), cervical incompetence（4.9% vs 0.8%, P<0.001), placenta previa（2.9% vs 0.5%, P<0.001), abortion（14.5% vs 1.8%, P<0.001), premature delivery（<37 w)（12.0% vs 5.0%, P<0.001), and low-birth weight（7.9% vs 3.6%，P<0.001). The incidence of premature rupture of membranes（PROM) in normal control group was significantly higher than that in adenomyosis group（20.5% vs 12.8%, P<0.05). In patients with adenomyosis, the incidence of premature rupture of membranes of natural conception subgroup was higher than that in the ART（assisted reproductive technology) group, while there was no significant difference in the incidence of abortion, premature delivery and the other pregnancy complications between these two subgroups. ConclusionAdenomyosis would increase the incidence of abortion, premature delivery and the incidence of pregnancy complications in pregnant women, while which are not affected by the in the method of conception in those with adenomyosis.