Background: To evaluate the relationship between gestational age, risk factors, pregnancy outcomes, and the causes and trends of the changes in the incidence of pregnancy in different years after the two-child policy. Methods:The study enrolled all of the childbirth women (n=7,016) from January 1st, 2015 to December 31th, 2017 in the Zhujiang Hospital. According to the age of all childbirth women, they were divided into four groups: ≤24, 25-29, 30-34 and ≥35 years old. While 20-29 years old group regarded as the control group (OR =1). Pregnancy complications and outcomes data of 4 groups were collected. χ 2 test and binarylogistic regression used as the analyze method. Stratified chi-square used to compare the rates between the pregnancy risk factors, childbirth modes and pregnancy outcomes in different years, which may be affected by the age.Results: Compared with the other groups, women in ≥35 years old showed the highest incidences of chronic medical complications and pregnancy induced complications, so as the abnormal neonatal birth outcomes. While women in ≤24 years old displayed a high risk of preeclampsia. After the childbearing policy change, the maternal age ratio increased year by year. The incidences of various risk factors, delivery modes and adverse pregnancy outcomes were also changed between different years and different age groups. The differences of annual incidence showed a statistical significance besides oligohydramnios. Conclusions:The study indicated that the changes in childbearing policy lead to the changes of age distribution proportion, which finally caused the changes of risk factors incidence. Furthermore, the advance of medical technology and society also affected the changes of pregnancy risk factors, delivery modes and the pregnancy outcomes in different years.
Objective We aimed to compare the 5‐year oncological outcomes of laparoscopic/abdominal radical hysterectomy (LRH/ARH) in patients with cervical adenosquamous carcinoma at stage IA2 to IIA2 based on the 2009 or 2018 International Federation of Gynecology and Obstetrics (FIGO) staging criteria. Methods Based on the clinical diagnosis and treatment of cervical cancer in China (Four C) database, Cox risk regression models were applied to analyze tumor prognosis treated with ARH/LRH in FIGO 2009 and 2018 IA2‐IIA2 patients and stratified findings according to tumor diameter (≤4 and >4 cm subgroups). And to avoid bias, propensity score matching (PSM) was also used for the cohort study. Results Based on FIGO 2009 staging criteria (n = 474), there was no significant difference between the ARH and LRH groups in 5‐year disease‐free survival (DFS) or overall survival (OS). Lymph node metastasis was a risk factor for 5‐year DFS in this stage. After PSM, lymphovascular space invasion (LVSI) was an independent risk factor for 5‐year OS in the tumors ≤4 cm subgroup. Based on FIGO2018 staging criteria (n = 322), cervical interstitial infiltration depth was an independent risk factor for 5‐year OS in the total population and the tumor diameter ≤4 cm subgroup. Conclusions Laparoscopic surgery was not a risk factor affecting the oncologic prognosis of adenosquamous carcinoma of the cervix based on either FIGO 2009 or 2018 staging of stage IA2‐IIA2. In addition, LRH may be considered for patients with early‐stage cervical adenosquamous carcinoma.
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