目的 了解高龄初产妇妊娠晚期症状的发生现状，识别其症状群并分析影响因素，为症状管理实践的发展提供参考。方法 采用自行设计的一般资料调查表和妊娠晚期孕妇症状自评问卷对宁夏某妇女儿童医院门诊产检的235名高龄初产妇进行调查。采用探索性因子分析提取症状群，采用多元线性回归分析明确其影响因素。结果 回收有效问卷217份。本次调查发生率最高的6种症状为腰痛（87.1%）、尿频（84.8%）、乏力（82.5%）、呼吸困难（81.1%）、口干（80.2%）、睡眠障碍（78.8%）。探索性因子分析提取3个症状群分别命名为躯体-睡眠症状群、乏力-疼痛症状群、情绪相关症状群。妊娠前运动情况、妊娠前BMI是躯体-睡眠症状群和乏力-疼痛症状群的影响因素调整后R²=0.126，F=6.173，P<0.001；调整后R²=0.156，F=5.140，P=0.006）；学历、家庭人均月收入是情绪相关症状群的影响因素（调整后R²=0.107，F=2.606，P=0.045）。结论 正常高龄初产妇妊娠晚期会经历多种症状，且以症状群的形式出现，护理人员应根据该人群特征，制订症状管理方案，保障其安全舒适，促进母婴健康。

Objective To understand the severity and distress of late pregnancy symptoms in elderly primiparas and identify the distribution characteristics of their symptom groups and analyze their influencing factors，so as to provide reference for the development of symptom management practice. Methods Elderly primiparas who met the criteria were investigated by a self-designed general data questionnaire and a self-assessment questionnaire for symptoms of pregnant women in the third trimester in a women’s and children’s hospital in Ningxia. Symptom groups were extracted by exploratory factor analysis，and multiple linear regression analysis was used to determine the influencing factors. Results A total of 217 valid questionnaires were collected. The six symptoms with the highest incidence were lumbago （87.1%），frequent urination （84.8%），fatigue （82.5%），dyspnea （81.1%），dry mouth （82.0%） and sleep disorders （78.8%）. Exploratory factor analysis revealed three symptom groups，namely somatic-sleep symptom cluster，fatigue-pain symptom cluster，and mood-related symptom cluster. Pre-pregnancy exercise and pre-gestational BMI were the influencing factors for the occurrence of somatic-sleep and fatigue-pain symptom clusters in advanced primipara in late pregnancy（adjusted R²=0.126，F=6.173，P<0.001；adjusted R²=0.156，F=5.140，P=0.006）. Educational background and monthly household income were the influencing factors for the occurrence of mood-related symptom cluster in advanced primipara in late pregnancy（adjusted R²=0.107，F=2.606，P=0.045）. Conclusion Advanced primiparas experience a variety of symptoms in late pregnancy and in the form of symptom clusters. Nursing staffs should develop targeted symptom management program based on the characteristics to ensure their safety and comfort.