中国全科医学 ›› 2021, Vol. 24 ›› Issue (5): 581-584,602.DOI: 10.12114/j.issn.1007-9572.2021.00.070

所属专题: 儿科最新文章合集

• 专题研究 • 上一篇    下一篇

晚期早产儿小于胎龄儿围生期呼吸系统并发症的危险因素研究

袁二伟*,郭华贤,许津莉,赵文慧,赵美林,王玲玲   

  1. 075000 河北省张家口市,河北北方学院附属第一医院儿内科
    *通信作者:袁二伟,主治医师;E-mail:13931306056@163.com
  • 出版日期:2021-02-15 发布日期:2021-02-15
  • 基金资助:
    基金项目:河北省医学科学研究重点课题计划(20180852)

Risk Factors Associated with Perinatal Respiratory Complications in Late Preterm Small for Gestational Age Infants 

YUAN Erwei*,GUO Huaxian,XU Jinli,ZHAO Wenhui,ZHAO Meilin,WANG Lingling   

  1. Department of Pediatrics,the First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China
    *Corresponding author:YUAN Erwei,Attending physician;E-mail:13931306056@163.com
  • Published:2021-02-15 Online:2021-02-15

摘要: 背景 小于胎龄儿体格发育较适于胎龄儿差,易合并呼吸窘迫综合征、肺部感染、喂养不耐受、脑瘫、生长发育落后等并发症,其中晚期早产儿小于胎龄儿的呼吸系统疾病发生率显著高于适于胎龄儿,而关于晚期早产儿小于胎龄儿围生期呼吸系统并发症危险因素的相关研究目前相对较少。目的 探讨晚期早产儿小于胎龄儿围生期呼吸系统并发症发生情况及其相关危险因素。方法 选取河北北方学院附属第一医院2015年1月—2017年1月收治的100例晚期早产儿(剔除大于胎龄儿)的临床资料进行回顾分析。根据新生儿出生时体质量分为小于胎龄儿组(n=45)和适于胎龄儿组(n=55),比较两组呼吸系统并发症的发生情况。另根据小于胎龄儿组中是否发生呼吸系统并发症分为疾病亚组(n=28)和非疾病亚组(n=17),对母亲和新生儿可能的相关因素进行单因素分析。采用多因素Logistic回归分析晚期早产儿小于胎龄儿围生期呼吸系统并发症的危险因素。结果 小于胎龄儿组围生期呼吸系统并发症发生率高于适于胎龄儿组(62.2%与41.8%,χ2=4.122,P<0.05)。疾病亚组母亲相关因素中妊娠期高血压、多胎妊娠、孕期感染、脐带异常、宫内窘迫、孕晚期发热、胎膜早破、窒息史、胎盘早剥发生率及新生儿相关因素中脓毒症发生率高于非疾病亚组(P<0.05)。多因素Logistic回归分析显示,妊娠期高血压、多胎妊娠、孕期感染、脐带异常、宫内窘迫、孕晚期发热、胎膜早破、窒息史、新生儿脓毒症为发生呼吸系统并发症的危险因素(P<0.05)。结论 晚期早产儿小于胎龄儿围生期呼吸系统并发症发生率高于适于胎龄儿,妊娠期高血压、多胎妊娠、孕期感染、脐带异常、宫内窘迫、孕晚期发热、胎膜早破、窒息史、新生儿脓毒症是引起晚期早产儿小于胎龄儿围生期呼吸系统并发症的高危因素。

关键词: 婴儿, 早产, 疾病, 晚期早产儿, 婴儿, 小于胎龄, 呼吸系统并发症, 危险因素

Abstract: Background The physical development of small-for-gestational-age(SGA) infants is poorer than that of appropriate-for-gestational-age(AGA) infants,and they are prone to complications such as respiratory distress syndrome,pulmonary infection,feeding intolerance,cerebral palsy,growth and development retardation.In particular,late preterm SGA infants are more susceptible to respiratory diseases.However,there are relatively few studies on the risk factors of perinatal respiratory complications in late preterm SGA infants.Objective To investigate the occurrence and risk factors of perinatal respiratory complications in late preterm SGA infants.Methods A retrospective analysis was conducted on the clinical data of late preterm infants(n=100)admitted to the First Affiliated Hospital of Hebei North University from January 2015 to January 2017 except large-for-gestational-age infants.They were then divided into SGA infants(n=45)and AGA infants(n=55)based on birth weight and were compared in terms of perinatal respiratory complications incidence.Univariate analysis was used to screen maternal and infant-related factors possibly associated with infant respiratory complications by comparing SGA infants with respiratory complications(n=28)and those without(n=17),and the identified high-risk factors were further analyzed with multivariate Logistic regression.Results The incidence of perinatal respiratory complications in SGA infants was significantly higher than that of AGA infants(62.2% vs. 41.8%,χ2=4.122,P<0.05).SGA infants with respiratory complications had higher prevalence of maternal-related factors associated with infant respiratory complications,including pregnancy-induced hypertension,multiple pregnancy,umbilical cord abnormalities,intrauterine distress,late pregnancy fever,premature rupture of membranes,history of asphyxia,and placental abruption,and higher prevalence of neonatal sepsis compared with those(P<0.05).Multivariate Logistic regression analysis showed that pregnancy-induced hypertension,multiple pregnancy,infection during pregnancy,umbilical cord abnormalities,intrauterine distress,late pregnancy fever,premature rupture of fetal membranes,history of asphyxia,and neonatal sepsis were significantly associated with perinatal respiratory complications in late preterm SGA infants(P<0.05).Conclusion  Late preterm SGA infants may have higher incidence of perinatal respiratory complications than late preterm AGA infants,which may be closely associated with maternal pregnancy-induced hypertension,multiple pregnancy,infection during pregnancy,umbilical cord abnormalities,intrauterine distress,late pregnancy fever,premature rupture of membranes,history of asphyxia,and neonatal sepsis.

Key words: Infant, premature, diseases;Late preterm infants;Infant, small for gestational age;Respiratory complications;Risk factors