[摘要] 目的 探究和分析引?l产妇早产的相关因素以及早产儿的妊娠结局。方法 方便选择该院自2016年1―12月收治的90例分娩早产病例作为研究组,并选择90例同期分娩的足月病例作为对照组,通过对比两组产妇的临床资料及妊娠结局,分析引发产妇早产的相关危险因素以及对早产儿妊娠结局的影响。结果 研究组产妇年龄>35岁(15.6%),胎盘植入、胎盘早剥(10.0%)、流产史(30.0%)、早产史(31.1%)、未正规产检(17.8%)、产前出血(23.3%)、胎膜早破(33.3%)、妊娠期肝内胆汁淤积(8.9%)、子痫前期(35.6%)、羊水过少(24.4%)、胎儿宫内窘迫(26.7%)高于对照组产妇年龄>35岁(3.3%)、胎盘植入、胎盘早剥(2.2%)、流产史(5.6%)、早产史(4.4%)、未正规产检(7.8%)、产前出血(5.6%)、胎膜早破(12.2%)、妊娠期肝内胆汁淤积(1.1%)、子痫前期(6.7%)、羊水过少(7.8%)、胎儿宫内窘迫(6.7%),且以上比较差异有统计学意义;另外,早产儿出生体重越轻、胎龄越小,其并发缺血缺氧性脑病、呼吸窘迫综合征、窒息、肺炎以及死亡的概率越大。结论 产妇早产和产妇的年龄大于35岁、胎盘植入、胎盘早剥、流产史、早产史等多种因素有关,产妇及临床需根据这些因素做好相关的防预措施,才能有效降低早产儿的发生率和改善早产儿妊娠结局。
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[关键词] 早产;相关因素;早产儿结局
[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742(2018)01(c)-0102-03
[Abstract] Objective This paper tries to explore and analyze the related factors of premature delivery and the pregnancy outcome of premature infants. Methods 90 cases of preterm birth cases were selected from January to December 2016. 90 cases of full-term delivery were convenient selected of the same period as the control group. By comparing the clinical data and pregnancy of the two groups, the causes of maternal preterm birth related risk factors and the impact of premature infant pregnancy outcome were analyzed. Results The maternal age above 35 years old in the treatment group (15.6%), placenta implantation, placental abruption (10.0%), history of abortion(30.0%), premature birth history (31.1%), not regular prenatal(17.8%), antepartum haemorrhage(23.3%), premature rupture of membranes(33.3%), intrahepatic cholestasis during pregnancy (8.9%), preeclampsia (35.6%), oligohydramnios (24.4%), fetal distress (26.7%), higher than the control group whose age above 35 years old (3.3%), placenta implantation, placental abruption (2.2%), history of abortion (5.6%), premature birth history (4.4%), not regular prenatal (7.8%), antepartum haemorrhage (5.6%), premature rupture of membranes (12.2%), intrahepatic cholestasis during pregnancy (1.1%), preeclampsia (6.7%), oligohydramnios (7.8%), fetal distress (6.7%), and the above were statistically significantly different in contrast; In addition, preterm infants were born with a lower weight and younger age, and the greater the risk of ischemic encephalopathy, respiratory distress syndrome, asphyxia, pneumonia and death. Conclusion Maternal preterm birth and women older than 35 years old, placenta implantation, placental abruption, history of miscarriage, premature birth history and other factors, maternal and clinical needs to make relevant prevention measures according to these factors, which can effectively reduce the incidence of preterm infants and improve pregnancy outcome in preterm neonates. [Key words] Premature delivery; Related factors; Premature children outcome
早产儿是指妊娠28~37周之间终止妊娠分娩出的新生儿,有资料显示,在分娩总数中早产病例占5%~15%,并且由于早产出生的新生儿组织器官发育多不成熟,因此其并发各种疾病的概率及死亡率比足月新生儿高得多,且在存活的早产儿中,有不少患儿会发生智力障碍、机体功能障碍、各个系统功能障碍以及结构异常等,不仅不利于其自身的健康成长,同时对其家庭也是承重的负担。为此探究引发产妇早产的相关因素,并根据相关因素进行针对性的干预和预防,对改善产妇妊娠结局和降低早产儿的发生率具有重要的临床意义[1]。该研究现将2016年1―12月该院收治的90例早产相关因素以及早产儿的妊娠结局报道如下。
1 资料与方法
1.1 一般资料
方便选择该院收治的90例分娩早产病例作为研究组,并选择90例同期分娩的足月病例作为对照?M,两组产妇均为单胎妊娠。其中,研究组的90例产妇中,年龄26~39岁,28例有过孕史;对照组的90例产妇中,年龄在4~35岁,26例有过孕史。对比两组患者的年龄、孕史等一般性资料发现,差异无统计学意义(P>0.05),具有对比性。
1.2 方法
收集和对比两组产妇的临床资料,包括产妇年龄、身高、体重、胎盘情况、孕史、流产史、早产史、产检情况、产前出血情况、胎膜早破、妊娠期肝内胆汁淤积、子痫前期、羊水情况、胎儿宫内生长情况等。并根据早产儿的体重不同,将其分成>2 500 g组、2 000~2 500 g组、1 500~2 000 g组及34周组、32~34周组、30~32周组及0.05),研究组产妇年龄>35岁、胎盘植入、胎盘早剥、流产史、早产史、未正规产检、产前出血、胎膜早破、妊娠期肝内胆汁淤积、子痫前期、羊水过少、胎儿宫内窘迫等发生率明显高于对照组,两组对比差异有统计学意义(P35岁、胎盘植入、胎盘早剥、流产史、早产史、未正规产检、产前出血、胎膜早破、妊娠期肝内胆汁淤积、子痫前期、羊水过少、胎儿宫内窘迫等,这可能与高龄产妇机体的各项器官功能发生衰退以及其在妊娠期间易并发高血压、妊娠期糖尿病等因素有关[3-4]。其中:研究组产妇的流产史、早产史发生率高达30.0%、31.1%,这可能与产妇以往生殖器官的损伤有很大的关系;另外,产妇在妊娠期间未行正规产检也是引发其出现早产的高危因素,研究组的发生率达到了17.8%,这与孕妇孕期机体各项免疫功能较低,易出现异常情况,而无法对其出现的异常情况进行及时干预或治疗有很直接的关系[5-7];相关研究发现[8],在所有的早产妇中,因胎盘早剥导致的人数占11.0%,这说明胎盘早剥是早产的一大因素,其与胎盘早剥引发孕妇发生阴道出血,进而并发阴道炎及贫血等症状有很大的关系;此外,胎膜早破也是胎盘因素引发的并发症之一,同时也是引发产妇早产的重要危险因素。
该次研究中早产妊娠分娩的早产儿的出生体重及胎龄差异有统计学意义,其中以出生体重低于35岁、胎盘因素、未正规产检、胎膜早破、子痫前期、羊水过少、胎儿宫内窘迫等,且早产儿出生体重越轻、胎龄越小,其并发缺血缺氧性脑病、呼吸窘迫综合征、窒息、肺炎以及死亡的概率越大,产妇及临床需根据这些因素做好相关的防预措施,才能有效降低早产儿的发生率和改善早产儿的妊娠结局。
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(收稿日期:2017-10-23)