新生儿窒息高危因素分析及干预对策
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摘要
目的分析产科导致新生儿窒息的高危因素,为临床制定新生儿窒息防范措施提供参考,以期降低新生儿窒息率,提升母婴健康水平。方法选择2016年1月至2018年1月在我院分娩发生新生儿窒息的孕妇184例作为观察组,另选择同期分娩未发生新生儿窒息的孕妇200例作为对照组。比较影响新生儿发生窒息的因素,如孕妇情况(年龄、产次、孕周、胎数等)、分娩情况(分娩方式、产前胎盘早剥、产前前置胎盘、胎儿宫内窘迫、脐带绕颈、臀位助产等)、胎儿因素(巨大儿、羊水污染、血清蛋白<30 g/L、伴随疾病、总胆红素≥17. 1μmol/L)间的差异,对有统计学意义的指标行多因素logistic回归分析.并根据上述高危因素制订预防新生儿窒息的对策。结果影响新生儿窒息的相关因素包含产妇年龄、产次、孕周、胎数、过期妊娠、骨盆狭小或畸形、合并糖尿病、合并重度贫血、产前胎盘早剥、胎儿宫内窘迫、脐带绕颈、羊水污染、剖宫产、巨大儿、胎儿发育异常、血清蛋白<30 g/L、胎儿伴随疾病、总胆红素≥17. 1μmol/L。经多因素logostic回归分析结果显示,高龄产妇、初产妇、孕周<35周、产前胎盘早剥、胎儿宫内窘迫、脐带绕颈、羊水污染是新生儿窒息的独立危险因素。结论影响新生儿窒息的危险因素较多,应做好产前综合评估,对于影响新生儿窒息高危因素进行对症干预,可降低新生儿窒息率,提高母婴安全。
Objective To analyze the high-risk factors of neonatal asphyxia caused by obstetrics,thus providing reference for the clinical development of neonatal asphyxia prevention measures. Therefore,it can meet the aims of reducing the neonatal asphyxia rate and improving maternal and child health.Methods A total of 184 pregnant women with neonatal asphyxia who gave birth in our hospital from January 2016 to January 2018 were selected as the observation group,and 200 pregnant women who didn't have neonatal asphyxia at the same time were selected as the control group. The difference of factors affecting neonatal asphyxia,such as maternal conditions( including age,parity,gestational age,number of fetuses,etc.),childbirth condition( including delivery mode,prenatal placental abruption,prenatal placenta previa,fetal distress,circular of umbilical cord and assisted breech delivery),as well as fetal factors( including fetal macrosomia,amniotic fluid contamination,serum protein < 30 g/L,concomitant disease,and total bilirubin≥17. 1 μmol/L)were compared. Regarding the statistically significant indicators,multi-factor logistic regression analysis was conducted to analyze these indicators. According to the above-mentioned high-risk factors,measures were formulated to prevent neonatal asphyxia. Results Factors affecting neonatal asphyxia included maternal age,parity,gestational age,number of fetuses,overdue pregnancy,pelvic stenosis or deformity,diabetes mellitus,severe anemia,prenatal placental abruption,fetal distress,circular of umbilical cord,amniotic fluid contamination,cesarean section,fetal macrosomia,fetal dysplasia,serum protein < 30 g/L,concomitant disease,and total bilirubin≥17. 1 μmol/L. Multivariate logistic regression analysis showed that elderly parturient women,primiparas,gestational weeks < 35 weeks,prenatal placental abruption,fetal distress,circular of umbilical cord and amniotic fluid contamination were independent risk factors for neonatal asphyxia. Conclusion There are many risk factors affecting neonatal asphyxia. So comprehensive prenatal evaluation should be conducted. Symptomatic intervention for high risk factors affecting neonatal asphyxia can reduce neonatal asphyxia rate and improve maternal and child safety.
Objective To analyze the high-risk factors of neonatal asphyxia caused by obstetrics,thus providing reference for the clinical development of neonatal asphyxia prevention measures. Therefore,it can meet the aims of reducing the neonatal asphyxia rate and improving maternal and child health.Methods A total of 184 pregnant women with neonatal asphyxia who gave birth in our hospital from January 2016 to January 2018 were selected as the observation group,and 200 pregnant women who didn't have neonatal asphyxia at the same time were selected as the control group. The difference of factors affecting neonatal asphyxia,such as maternal conditions( including age,parity,gestational age,number of fetuses,etc.),childbirth condition( including delivery mode,prenatal placental abruption,prenatal placenta previa,fetal distress,circular of umbilical cord and assisted breech delivery),as well as fetal factors( including fetal macrosomia,amniotic fluid contamination,serum protein < 30 g/L,concomitant disease,and total bilirubin≥17. 1 μmol/L)were compared. Regarding the statistically significant indicators,multi-factor logistic regression analysis was conducted to analyze these indicators. According to the above-mentioned high-risk factors,measures were formulated to prevent neonatal asphyxia. Results Factors affecting neonatal asphyxia included maternal age,parity,gestational age,number of fetuses,overdue pregnancy,pelvic stenosis or deformity,diabetes mellitus,severe anemia,prenatal placental abruption,fetal distress,circular of umbilical cord,amniotic fluid contamination,cesarean section,fetal macrosomia,fetal dysplasia,serum protein < 30 g/L,concomitant disease,and total bilirubin≥17. 1 μmol/L. Multivariate logistic regression analysis showed that elderly parturient women,primiparas,gestational weeks < 35 weeks,prenatal placental abruption,fetal distress,circular of umbilical cord and amniotic fluid contamination were independent risk factors for neonatal asphyxia. Conclusion There are many risk factors affecting neonatal asphyxia. So comprehensive prenatal evaluation should be conducted. Symptomatic intervention for high risk factors affecting neonatal asphyxia can reduce neonatal asphyxia rate and improve maternal and child safety.
引文
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[13]曾丽萍,梁秋红,何苑苑.围生期高危因素与新生儿窒息的关系分析[J].医学综述,2015,21(12):2271-2273.
[14]周玲玲.新生儿窒息与产科高危因素的临床分析[J].临床医药文献杂志,2015,2(11):2137-2137.
[15]邓秀莲.产科相关高危因素致新生儿窒息的临床分析[J].中国医药指南,2017,15(4):24-25.
[16]赵蔓.胎儿窘迫及新生儿窒息的围产期高危因素调查研究[J].中国妇幼保健,2016,31(16):3375-3377.
[2]曾秋莲.60例新生儿窒息产妇的临床护理体会[J].护理实践与研究,2014,11(5):79-80.
[3]黄日妹.个性化护理对新生儿窒息后血糖尿常的影响[J].护理实践与研究,2015,12(10):55-56.
[4]余艳芳.新生儿窒息与产科相关因素的临床分析[J].中国社区医师,2015,31(19):21-22.
[5]Abiramalatha T,Kumar M,Chandran S,et al.Troponin-T as a biomarker in neonates with perinatal asphyxia[J].J Neonatal Perinatal Med,2017,10(3):275-280.
[6]陈巧燕.新生儿窒息的产科原因探讨[J].中国实用医药,2015,10(1):231-232.
[7]Isac S,Panaitescu AM,Spataru A,et al.Trans-resveratrol enriched maternal diet protects the immature hippocampus from perinatal asphyxia in rats[J].Neurosci Lett,2017(653):308-313.
[8]朱芬菊.新生儿窒息产科原因分析[J].中国农村卫生,2015(20):28-29.
[9]Nevalainen P,Marchi V,Mets9ranta M,et al.Evoked potentials recorded during routine EEG predict outcome after perinatal asphyxia[J].Clin Neurophysiol,2017,128(7):1337-1343.
[10]赵仙芝.胎儿窘迫及新生儿窒息的围产期高危因素分析[J].实用临床医药杂志,2016,20(11):201-202.
[11]付敏,张云芳.新生儿窒息的产科原因分析[J].国际医药卫生导报,2015,21(17):2543-2544.
[12]刘秀.产科综合干预对预防新生儿窒息事件发生的效果分析[J].临床研究,2015,23(6):102-103.
[13]曾丽萍,梁秋红,何苑苑.围生期高危因素与新生儿窒息的关系分析[J].医学综述,2015,21(12):2271-2273.
[14]周玲玲.新生儿窒息与产科高危因素的临床分析[J].临床医药文献杂志,2015,2(11):2137-2137.
[15]邓秀莲.产科相关高危因素致新生儿窒息的临床分析[J].中国医药指南,2017,15(4):24-25.
[16]赵蔓.胎儿窘迫及新生儿窒息的围产期高危因素调查研究[J].中国妇幼保健,2016,31(16):3375-3377.