目的 识别妊娠合并法洛四联症（TOF）孕妇剖宫产后结局的风险因素。方法 回顾性分析了2011年5月至2020年5月在首都医科大学附属北京安贞医院收治的42例妊娠合并TOF孕妇的产后结局。通过逻辑回归模型识别产后结局的相关风险因素。结果 42例中没有发生孕妇死亡者，16例孕妇发生产后不良结局，18例（42.86%）术前纽约心脏病学会（NYHA）心功能分级Ⅲ~Ⅳ，10例（23.81%）术前未行TOF手术治疗，12例（28.57%）入室经皮血氧饱和度（SpO₂）<90%。没有发生新生儿死亡和新生儿窒息。研究发现，NYHA心功能分级Ⅲ~Ⅳ[比值比（OR）=9.43，95%置信区间（CI） 2.21~36.523，P=0.002]，未行TOF手术（OR=32.14，95%CI 3.46~298.78，P=0.002）、经皮SpO₂<90%（OR=9.10，95%CI 1.92~43.19，P=0.005）、室间隔缺损（OR=32.14，95%CI 3.46~298.78，P=0.002）、紫绀（OR=25.00，95%CI 2.70~231.59，P=0.005）、未行多学科协作（MDT）模式（OR=7.00，95%CI 1.72~28.55，P=0.007）是发生妊娠合并TOF孕妇产后不良结局的危险因素。结论 未行TOF手术治疗、合并室间隔缺损、术前经皮SpO₂<90%、紫绀与产后不良结局相关。采用多学科诊疗模式将会改善产后结局。

Objective To identify the risk factors for postpartum outcomes of patients with pregnancy complicated by TOF after cesarean section. Methods A retrospective analysis was conducted on the postpartum outcomes of 42 patients with pregnancy complicated by TOF admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University from May 2011 to May 2020. Logistic regression model was used to identify the risk factors for postpartum outcomes. Results No maternal death occurred; 16 mothers had adverse postpartum outcomes，18（42.86%）had preoperative NYHA cardiac function classification of Ⅲ-Ⅳ，10 （23.81%） had no preoperative TOF surgery，and 12 （28.57%） had percutaneous SpO₂<90% upon admission. No neonatal death or neonatal asphyxia occurred. The study revealed that NYHA cardiac function classification of Ⅲ-Ⅳ（OR=9.43，95% CI 2.21-36.523，P=0.002），no TOF surgery （OR=32.14，95%CI 3.46-298.78，P=0.002），percutaneous SpO₂<90%（OR=9.10，95%CI 1.92-43.19，P=0.005），ventricular septal defect（OR=32.14，95% CI 3.46-298.74，P=0.002），cyanosis （OR=32.14，95%CI 3.46-298.78，P=0.002），and the absence of a multidisciplinary team （MDT）collaboration model （OR=7.00，95%CI 1.72-28.55，P=0.007）were risk factors for adverse postpartum outcomes of patients with pregnancy complicated by TOF. Conclusions No preoperative TOF surgery，complication with ventricular septal defect，preoperative percutaneous SpO₂<90%，and cyanosis seem to be associated with adverse postpartum outcomes. The application of the multidisciplinary diagnosis and treatment model may improve postpartum outcomes.