摘要：目的 分析2022—2024年深圳市福田区危重症孕产妇不同亚组（不同并发症/合并症）的流行病学特征、病因构成及相关因素，为优化区域孕产妇健康管理提供依据。方法 基于福田区危重症孕产妇监测网络，对2022年1月1日至2024年12月31日期间107921例孕产妇个案资料进行回顾性描述性分析，采用描述性流行病学方法及卡方检验分析不同因素与危重症主要并发症的关联。结果 深圳市福田区3年间危重症孕产妇共729例，总体发生率为6.75‰。各年度发生率分别为2022年6.67‰、2023年7.38‰和2024年6.33‰。危重症孕产妇中，≥35岁者占33.7%，本科及以上学历者占53.8%。初检妊娠风险评级为黄色者占比最高（41.98%），高危者占21.9%。最常见并发症为产后出血（43.89%），其次为宫缩乏力（17.28%）、前置胎盘（16.59%）、子痫/子痫前期（14.67%）和胎盘植入（13.99%）。血液系统疾病为最常见合并症（57.75%），内分泌系统疾病次之（24.42%）。单因素分析显示，产后出血的发生与高龄、产检次数不足5次、经产妇身份存在统计学关联（均P<0.05）；前置胎盘的发生与高龄、低学历、非汉族、初检高危评级、产检不足5次、经产存在统计学关联（均P<0.05）。结论 深圳市福田区危重症孕产妇发生率约为6.75‰，产后出血和前置胎盘为主要并发症。单因素分析显示，高龄、产检不足、初检高危分级及经产与上述主要并发症的发生相关。应加强动态妊娠风险管理和多学科协作，完善产科早期预警体系，以降低危重症孕产妇发生率，提高母婴安全水平。
Abstract: Objective To analyze the epidemiological characteristics, etiology composition, and related factors of critically ill pregnant women in Futian District, Shenzhen, from 2022 to 2024. Methods Based on the surveillance network, a retrospective descriptive analysis was conducted on 107,921 pregnant women. Chi-square tests were used to analyze the association between different factors and major complications. Results A total of 729 critically ill pregnant women were identified (overall incidence 6.75‰).??The most common complication was postpartum hemorrhage (43.89%), followed by uterine atony (17.28%), placenta previa (16.59%), eclampsia/preeclampsia (14.67%), and placenta accreta (13.99%). Univariate analysis showed that postpartum hemorrhage was statistically associated with advanced age, <5 antenatal visits, and multiparity (all P<0.05). Placenta previa was statistically associated with advanced age, low education level, non-Han ethnicity, high-risk initial assessment, <5 antenatal visits, and multiparity (all P<0.05). Conclusion The incidence of critically ill pregnant women in Futian District is approximately 6.75‰. Univariate analysis suggested that advanced age, insufficient antenatal visits, high-risk classification, and multiparity were associated with the main complications. Dynamic risk management and multidisciplinary collaboration should be strengthened.
