Analysis on clinical characteristics of multipara in 15 hospitals in Beijing area: a systematic cluster sampling survey / 中华围产医学杂志

ABSTRACT

Objective To investigate the clinical characteristics (social background,comorbidity,complications and outcomes of pregnancy) of multipara in Beijing area.Methods A systematic cluster sampling survey was conducted on 15 194 pregnant women who gave birth at 15 hospitals in Beijing from January to June in 2013.The age,gestational weeks at delivery,education background,geographical distribution,health insurance coverage,mode of delivery,comorbidity and complications of pregnancy,pregnant outcomes and other relevant clinical data were collected and analyzed with two-sample t test or Chi-square test.Results The proportion of multipara in Beijing area was 21.12％ (3 209/15 194),the per capita number of delivery was 1.23 (18 745/15 194).The ratio of women with higher education background,average monthly household income over 3 000 yuan,urban residence and social insurance in multipara were much lower than those in primipara (all P＜0.05).The mean maternal age of multipara was (30.02±4.88) years,pre-pregnancy body mass index was 22.24 ± 3.48,which were all higher than those of primipara [(27.82 ± 4.03) years and 21.54 ± 3.29,respectively,t=23.440 and 11.115,all P＜0.01].And the gestational weeks at delivery and mean weight gain during pregnancy of multipara was less than that of primipara [(39.15 ±1.67) vs (39.49 ± 1.67) weeks,t=-14.044,P=0.000;(14.66±6.24) vs (15.81 ± 5.86) kg,t=-9.448,P=0.000],while the levels of total cholesterol,triglyceride and low density lipoprotein-cholesterol and the incidence of macrosomia were significantly higher [(5.59± 1.14) vs (5.24± 1.15) mmol/L,(2.31± 1.38) vs (1.96± 1.34) mmol/L,(3.03±0.91) vs (2.82±0.87) mmol/L,t=12.867,15.718 and 10.275,all P＜0.01;9.29％ (298/3 209) vs 7.24％ (868/11 985),x2=14.926,P=0.000].Significantly lower incidences of abnormal amniotic fluid volume,premature rupture of membranes,fetal distress,abnormal labor and vaginal delivery (all P ＜ 0.01),but higher neonatal birth weight [(3 374.38 ±504.57) vs (3 328.39±488.70) g,t=4.839,P=0.000] and cesarean section rate [45.96％ (1 475/3 209) vs 42.49％(5 092/11 985),x2=12.477,P＜0.01] were found in multipara than in primipara.Compared with primipara,multipara had higher incidence of gestational diabetes mellitus,diabetes during pregnancy,pregnancy complicated with cardiovascular problems,hypertensive disorder complicating pregnancy [adjusted OR(95％CI)1.265 (1.135-1.411),1.799 (1.215 2.663),1.567 (1.221-2.347),1.647 (1.300-2.086),all P＜0.01].Conclusions The primipara is the major reproductive population in Beijing area.However,the multipara requires close antenatal care because of their susceptibility to pregnant complications.