2025 年第 2 期 第 20 卷

妊娠合并无器质性心脏病心律失常患者的妊娠结局分析

Analysis of pregnancy outcomes of pregnant women with arrhythmia without structural heart disease

作者：张大伟陆育秋赵赫张军杨冬

英文作者：Zhang Dawei Lu Yuqiu Zhao He Zhang Jun Yang Dong

单位：首都医科大学附属北京安贞医院妇产科，北京100029

英文单位：Department of Obstetrics and Gynaecology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：妊娠合并心律失常；妊娠结局；无器质性心脏病心律失常

英文关键词：Pregnancycomplicatedwitharrhythmia;Pregnancyoutcome;Arrhythmiawithoutstructuralheartdisease

• 摘要：

• 目的 探讨妊娠合并无器质性心脏病心律失常患者的妊娠结局并分析不良妊娠结局与心律失常类型的相关性。方法 收集2013年6月至2020年6月首都医科大学附属北京安贞医院妇产科收治的妊娠合并无器质性心脏病心律失常患者283例。将患者根据妊娠结局分为不良妊娠结局组和正常妊娠结局组，分析患者心律失常类型及其与不良妊娠结局的相关性。结果 283例妊娠合并无器质性心脏病心律失常的患者中发生不良妊娠结局124例，占43.8%，正常妊娠结局159例，占56.2%。124例不良妊娠结局患者中流产9例（7.3%）、早产22例（17.7%）、小于胎龄儿11例（8.9%）、巨大儿12例（9.7%）、胎儿宫内窘迫27例（21.8%）、死胎2例（1.6%）、妊娠期糖尿病32例（25.8%）、妊娠高血压17例（13.7%）、产后出血23例（18.5%）。不良妊娠结局组房性期前收缩和右束支传导阻滞比例均高于正常妊娠结局组（均P＜0.05）。结论 妊娠合并无器质性心脏病心律失常患者中有相当比例的人群可能会出现妊娠期糖尿病、胎儿宫内窘迫等不良妊娠结局事件，且房性期前收缩及右束支传导阻滞与不良结局事件的发生有一定相关性，需引起临床重视。

• Objective To investigate the pregnancy outcomes of pregnant women with arrhythmia without structural heart disease, and to analyze the correlation between adverse pregnancy outcomes and arrhythmia types. Methods A total of 283 pregnant women with arrhythmia without structural heart disease admitted to the Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University from June 2013 to June 2020 were collected. The patients were divided into the adverse pregnancy outcome group and the normal pregnancy outcome group according to the pregnancy outcome. The types of arrhythmia and their correlation with adverse pregnancy outcomes were analyzed. Results Among the 283 pregnant women with arrhythmia without structural heart disease, 124(43.8%) had adverse pregnancy outcomes and 159(56.2%) had normal pregnancy outcomes. Among the 124 cases with adverse pregnancy outcomes, 9 cases (7.3%) had abortion, 22 cases (17.7%) had preterm birth, 11 cases (8.9%) had small for gestational age, 12 cases (9.7%) had macrosomia, 27 cases (21.8%) had fetal distress, 2 cases (1.6%) had stillbirth, 32 cases (25.8%) had gestational diabetes mellitus, 17 cases (13.7%) had gestational hypertension and 23 cases (18.5%) had postpartum hemorrhage. The proportions of premature atrial contraction and right bundle branch block in the adverse pregnancy outcome group were higher than those in the normal pregnancy outcome group (both P＜0.05). Conclusion There is a considerable proportion of the population of pregnant women with arrhythmia without structural heart disease may have adverse pregnancy outcomes such as gestational diabetes mellitus and fetal intrauterine distress. Premature atrial contraction and right bundle branch block are related to the occurrence of adverse pregnancy outcomes, which need to be paid attention to in clinical practice.