湖北恩施土家族苗族自治州新生儿窒息发生情况及重度窒息发生影响因素的多中心研究
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摘要
目的了解湖北恩施土家族苗族自治州新生儿窒息的发生率及重度窒息发生的影响因素。方法选择湖北恩施土家族苗族自治州16家医院作为研究现场。收集2016年1～12月在该16家医院出生的活产婴儿22 294例的临床资料进行回顾性分析,调查新生儿窒息的发生率及重度窒息发生的影响因素。结果 22 294例活产新生儿中,733例(3.29%)诊断为新生儿窒息,其中轻度窒息627例,重度窒息106例。单因素分析显示,母亲文化程度低、孕期贫血、绒毛膜羊膜炎、羊水异常、脐带异常、前置胎盘、胎盘早剥以及民族为土家族的新生儿或早产出生、低出生体重者重度窒息发生率较高(P<0.05)。结论湖北恩施土家族苗族自治州新生儿窒息发生率较高。母亲文化程度低、孕期贫血、绒毛膜羊膜炎、脐带异常、羊水异常、前置胎盘、胎盘早剥及民族为土家族、早产出生、低出生体重可能与新生儿重度窒息的发生有关。
Objective To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture,China.Methods A total of16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers.A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December,2016to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia.Results Of the 22 294 neonates born alive,733(3.29%)were diagnosed with neonatal asphyxia,among whom 627 had mild asphyxia and 106 had severe asphyxia.The neonates with low maternal education level,maternal anemia during pregnancy,chorioamnionitis,abnormal amniotic fluid,abnormal umbilical cord,placenta previa,placental abruption,Tujia Minority,preterm birth,and low birth weight had a higher incidence of severe asphyxia(P<0.05).Conclusions The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher.Low maternal education level,maternal anemia during pregnancy,chorioamnionitis,abnormal amniotic fluid,abnormal umbilical cord,placenta previa,placental abruption,Tujia Minority,preterm birth,and low birth weight may be related to the development of severe neonatal asphyxia.
Objective To investigate the incidence of neonatal asphyxia and possible contributing factors for the development of severe asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture,China.Methods A total of16 hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture were selected as research centers.A retrospective analysis was performed for the clinical data of 22 294 live births in these 16 hospitals from January to December,2016to investigate the incidence rate of neonatal asphyxia and possible contributing factors for the development of severe asphyxia.Results Of the 22 294 neonates born alive,733(3.29%)were diagnosed with neonatal asphyxia,among whom 627 had mild asphyxia and 106 had severe asphyxia.The neonates with low maternal education level,maternal anemia during pregnancy,chorioamnionitis,abnormal amniotic fluid,abnormal umbilical cord,placenta previa,placental abruption,Tujia Minority,preterm birth,and low birth weight had a higher incidence of severe asphyxia(P<0.05).Conclusions The incidence rate of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture is higher.Low maternal education level,maternal anemia during pregnancy,chorioamnionitis,abnormal amniotic fluid,abnormal umbilical cord,placenta previa,placental abruption,Tujia Minority,preterm birth,and low birth weight may be related to the development of severe neonatal asphyxia.
引文
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[13]王文丽.150例新生儿窒息的高危因素及防护措施[J].中国妇幼保健,2015,30(9):1386-1388.
[14]史丹红,王艳,邹丹玲.2006-2015年深圳市龙岗区新生儿重度窒息调查及相关因素研究[J].中国妇幼卫生杂志,2016,7(6):26-28.
[15]Ensing S,Abu-Hanna A,Schaaf JM,et al.Trends in birth asphyxia,obstetric interventions and perinatal mortality among term singletons:a nationwide cohort study[J].J Matern Fetal Neonatal Med,2015,28(6):632-637.
[16]沈松英,魏雪灵,何健荣,等.妊娠期感染对胎婴儿生长发育的影响[J].中华围产医学杂志,2017,20(8):596-599.
[2]Xu T,Wang H,Gong L,et al.The impact of an intervention package promoting effective neonatal resuscitation training in rural China[J].Resuscitation,2014,85(2):253-259.
[3]中华医学会围产医学分会新生儿复苏学组.新生儿窒息诊断的专家共识[J].中华围产医学杂志,2016,19(1):3-6.
[4]中国新生儿复苏项目专家组.中国新生儿复苏指南(2016年北京修订)[J].中华围产医学杂志,2016,19(7):481-486.
[5]崔渺,冉素娟,吴峻峰.湖北省恩施州少数民族地区乡镇卫生院卫生资源现状调查[J].医学与哲学,2011,32(7):47-49.
[6]黄瑞芹.健康中国战略下民族地区农村居民健康素养提升策略研究--基于恩施土家族苗族自治州的农户调查[J].华中师范大学学报(人文社会科学版),2018,57(4):19-26.
[7]叶鸿瑁.再接再厉,继续深入开展我国的新生儿复苏工作[J].中华围产医学杂志,2016,19(1):12-14.
[8]金志彪,柳锡永.新生儿窒息发生率及危险因素分析[J].中国妇幼健康研究,2014,32(5):842-844.
[9]Semba RD,de Pee S,Sun K,et al.Effect of parental formal education on risk of child stunting in Indonesia and Bangladesh:a cross-sectional study[J].Lancet,2008,371(9609):322-328.
[10]管莉,王云,陈雪芹,等.母亲年龄、职业、文化程度与出生缺陷的关系[J].中华全科医学,2009,7(9):981-982.
[11]李智环,蒙小莺.土家族生育状况、原因及对策分析[J].湖南文理学院学报(社会科学版),2007,32(2):34-36.
[12]周兴茂,肖英.论土家族文化的基本特征[J].湖北民族学院学报(哲学社会科学版),2013,31(5):1-5.
[13]王文丽.150例新生儿窒息的高危因素及防护措施[J].中国妇幼保健,2015,30(9):1386-1388.
[14]史丹红,王艳,邹丹玲.2006-2015年深圳市龙岗区新生儿重度窒息调查及相关因素研究[J].中国妇幼卫生杂志,2016,7(6):26-28.
[15]Ensing S,Abu-Hanna A,Schaaf JM,et al.Trends in birth asphyxia,obstetric interventions and perinatal mortality among term singletons:a nationwide cohort study[J].J Matern Fetal Neonatal Med,2015,28(6):632-637.
[16]沈松英,魏雪灵,何健荣,等.妊娠期感染对胎婴儿生长发育的影响[J].中华围产医学杂志,2017,20(8):596-599.