Objective: To investigate the influence of maternal age on the health status of pregnant women and the pregnant outcomes. Methods: Data obtained from "Beijing perinatal health management registration system" was analyzed, 263 157 pregnant women with age information were included from October 1st, 2015 to September 30th, 2016, in which 43 594 women delivered at the age of 35 or above (advanced age) . According to the age of maternal age, there were 5 groups. (1) Proper age: 219 563 (83.43%, 219 563/263 157) cases of the age of 18-34 years, including 122 735 cases (46.64%, 122 735/263 157) in the ≤29 years old group and 96 828 cases (36.79%, 96 828/263 157) in 30-34 years old group. (2) Advanced age: there were 43 594 cases (16.57%, 43 594/263 157) ≥35 years old, including 37 395 cases (14.21%, 37 395/263 157) in the 35-39 years old group, 5 790 cases (2.20%, 5 790/263 157) in the 40-44 years old group and 409 cases (0.16%, 409/263 157) in the ≥45 years old group. The trend-based chi-square test and logistic regression were used to analyze the effects of different age groups on maternal complications and pregnant outcomes. Results: (1) The total incidence of high risk pregnancy (HRP) : in advanced age women, the incidence of HRP was 67.83% (29 571/43 594) which was 56.73% (124 550/219 563) in proper age women, the difference was statistically significant (χ(2)=1 848.91, P<0.000) . In advanced age women, the incidence of severe HRP was 7.64% (3 329/43 594) which was 6.18% (13 571/219 563) in proper age women, the difference was statistically significant (χ(2)=128.211, P<0.000) . In advanced age women, the incidence of very severe HRP was 1.76% (769/43 594) which was 0.84% (1 838/219 563) in proper age women, the difference was statistically significant (χ(2)=318.58, P<0.000) . (2) Comparison of the incidence of HRP in 5 groups:the total incidence of HRP increased through the following age group ≤29 years, 30-34 years, 35-39 years, 40-44 years, ≥45 years (53.28%, 61.09%, 67.41%、70.09%, 74.57% respectively) , the difference was statistically significant (linear by linear χ(2)=3 165.72, P<0.000) . The incidence of very severe HPR increased (0.66%, 1.06%, 1.66%, 2.35%, 2.93% respectively) , the difference was statistically significant (linear by linear χ(2)=218.31, P<0.000) . The incidence of severe HPR increased (5.77%, 6.70%, 7.48%, 8.34%, 11.49% respectively) , the difference was statistically significant (linear by linear χ(2)=422.20, P<0.000) . The incidence of general HPR increased (46.84%, 53.34%, 58.26%, 59.40%, 60.15% respectively) , the difference was statistically significant (linear by linear χ(2)=1 947.51, P<0.000) . (3) As the maternal age group increased, the incidence of adverse pregnancy outcomes increased (5.54%, 6.85%, 8.77%, 9.90%, 18.09%, linear by linear χ(2)=674.57, P<0.000) . The incidence of perinatal death, premature birth and low birth weight also presented the above trends (perinatal death: linear by linear χ(2)=34.79, P<0.000; premature birth: linear by linear χ(2)=692.87, P<0.000; low birth weight: linear by linear χ(2)=379.20, P<0.000) . (4) Logistic regression analysis with the assisted reproductive technology and multiple pregnancy considered showed the same trend (P<0.000) . Conclusion: The maternal age has an impact on the maternal health status and pregnancy outcomes, and the risk of various types of pregnancy complications and adverse pregnancy outcomes increase with the maternal age group, antenatal care and management should be emphasized in women with advanced maternal age, especially for women ≥40 years old.
目的： 探讨年龄对孕妇妊娠合并症、并发症及妊娠结局的影响。 方法： 对2015年10月1日至2016年9月30日北京市围产保健管理登记卡的资料进行分析，共纳入有分娩年龄信息的孕妇263 157例，按照孕妇的年龄共分为5组，（1）2组适龄孕妇：分娩年龄为18~34岁的适龄孕妇共219 563例（83.43%，219 563/263 157），其中≤ 29岁组122 735例（46.64%，122 735/263 157）及30~34岁组96 828例（36.79%，96 828/263 157）；（2）3组高龄孕妇：分娩年龄≥35岁的高龄孕妇共43 594例（16.57%，43 594/263 157），其中35~39岁组37 395例（14.21%，37 395/263 157）、40~44岁组5 790例（2.20%，5 790/263 157）及≥ 45岁组409例（0.16%，409/263 157），采用趋势χ(2)检验及logistics多因素分析，比较不同年龄段孕妇高危妊娠及不良妊娠结局的发生率，分析孕妇的年龄对其妊娠结局的影响。 结果： （1）总体高危妊娠的发生率：高龄孕妇高危妊娠的总发生率为67.83%（29 571/43 594），适龄孕妇为56.73%（124 550/219 563），两者比较，差异有统计学意义（χ(2)=1 848.91，P<0.000）。高龄孕妇严重高危妊娠的发生率为7.64%（3 329/43 594），适龄孕妇为6.18%（13 571/219 563），两者比较，差异有统计学意义（χ(2)=128.21，P<0.000）。高龄孕妇极严重高危妊娠的发生率为1.76%（769/43 594），适龄孕妇为0.84%（1 838/219 563），两者比较，差异有统计学意义（χ(2)=318.58，P<0.000）。（2）5组孕妇高危妊娠发生率的比较：≤29岁组、30~34岁组、35~39岁组、40~44岁组及≥45岁组孕妇随着年龄的增加，其总体高危妊娠的发生率也增加（分别为53.28%、61.09%、67.41%、70.09%、74.57%），5组比较，差异有统计学意义（趋势χ(2)=3 165.72，P<0.000）。5组孕妇极严重高危妊娠、严重高危妊娠、一般高危妊娠的发生率均增加（分别为0.66%、1.06%、1.66%、2.35%、2.93%；5.77%、6.70%、7.48%、8.34%、11.49%；46.84%、53.34%、58.26%、59.40%、60.15%），5组比较，差异均有统计学意义（趋势χ(2)=218.31，P<0.000；趋势χ(2)= 422.20，P<0.000；趋势χ(2)=1 947.51，P<0.000）。（3）5组产妇不良妊娠结局发生率的比较：5组孕妇随着年龄的增加，总体不良妊娠结局的发生率增加（5.54%，6.85%，8.77%，9.90%，18.09%；趋势χ(2)= 674.57，P<0.000），围产儿死亡、早产和低出生体质量儿的发生率也均增加（分别为趋势χ(2)=34.79，P<0.000；趋势χ(2)=692.87，P<0.000；趋势χ(2)=379.20，P<0.000）。（4）logistic多因素分析：考虑辅助生殖技术与多胎妊娠的影响，5组孕妇随着年龄的增加，不良妊娠结局的发生率仍增加（P<0.000）。 结论： 孕妇高龄对其妊娠期健康状况及妊娠结局均存在影响，妊娠合并症、并发症及不良妊娠结局的发生风险均随孕妇年龄增加而增高，应重视高龄孕妇的妊娠期管理，尤其应重视年龄≥40岁的高龄孕妇的围产保健。.
Keywords: Age factors; Pregnancy outcome; Pregnancy, high-risk.