目的：探讨巨大儿发生的高危因素及妊娠结局，为减少母婴并发症提供临床依据。方法将106例2009年1月～2012年1月于我院分娩巨大儿（出生体重≥4000g）的产妇作为观察组，随机选择观察期内分娩正常足月儿的产妇106例（2500g≤出生体重＜4000g）作为对照组，分析巨大儿发生的高危因素，比较两组产妇的分娩方式及分娩并发症。结果经产妇与初产妇巨大儿发生率的比较差异无统计学意义（P=0.285）。产妇宫高与腹围之和，B超所示胎儿双顶径、股骨长、胎儿腹围是产前预测巨大儿的相关因素（P均<0.05）。观察组的剖宫产率高于对照组，差异有统计学意义（P=0.012）；观察组的分娩并发症发生率高于对照组（P=0.000），经阴道分娩的巨大儿新生儿并发症高于剖宫产儿。结论产妇宫高与腹围之和，超声双顶径、股骨长、胎儿腹围是预测巨大儿发生的危险因素，应根据产妇自身条件，结合超声情况产前充分评估胎儿体重，合理选择分娩方式，减少母婴并发症。%Objective To explore the risk factors and pregnancy outcomes of macrosomia and provide clinical basis to decrease the maternal and infant complications. Methods 106 cases of delivery of macrosomia (birth weight≥4 000g) from Jan 2009 to Jan 2012 were selected as the observation group, 106 cases of normal weight delivery (2 500g≤birth weight<4 000g) in the same period were selected as control group, analyzed the risk factors of macrosomia and compared the delivery mode and complications. Results The incidence of macrosomia between multipare and pluripare had no statistically significant differ-ences (P=0.285). The sum of puerpera fundal height and abdomen circumference, BPD,FL, AC of the fetus were related to the prenatal prediction of macrosomia (P<0.05). Cesarean delivery rate of observation group was higher than the control group, and the difference was statistically significant (P=0.012);delivery complications rate of observation group was higher than the control group (P=0.000), neonatal complications in vaginal delivery mode of macrosomia were higher than the cesarean delivery. Conclusion The sum of puerpera fundal height and abdomen circumference,BPD,FL, AC of the fetus are risk factors for pre-dicting macrosomia fetus. Obstetrician should evaluate pregnant women based on their own conditions , combined with ultrasound fully assessed fetal weight, and choose reasonable way of delivery, reduce maternal and infant complications.
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