妊高征对超低出生体重早产儿并发症的影响
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摘要
目的分析妊娠期高血压综合征(妊高征)对早产超低出生体重(ELBW)儿并发症的影响。方法方便选取2012年2月—2017年5月在该院新生儿科住院的ELBW早产儿共45例,根据是否为妊高征母婴分为妊高征组和对照组,比较两组患儿生后短期主要并发症发生率及死亡率、住院时间等指标。结果妊高征组小于胎龄儿(SGA)(80.0%vs 40.0%,χ~2=7.287)及胆汁淤积(15.0%vs 0.0%,χ~2=4.018)发生率明显高于对照组,两组新生儿呼吸窘迫综合征(NRDS)、颅内出血-脑白质病变等发生率及住院时间、死亡率均差异无统计学意义;妊高征组NRDS患儿肺表面活性物质使用率明显低于对照组(40.0%vs 72.7%,χ~2=4.582)。结论母亲妊高征可增加ELBW早产儿SGA及胆汁淤积发生,但妊高征可能能减轻NRDS的严重程度。
Objective To analyze the effect of hypertensive syndrome of pregnancy(PIH) on the complications of preterm low ultra-low birth weight(ELBW). Methods A total of 45 ELBW premature infants were enrolled in the neonatology department of our hospital from February 2012 to May 2017. The children were convenient divided into the pregnancy-induced hypertension group and the control group according to whether they were pregnant or not. Short-term major complication rate and mortality, hospitalization time and other indicators were compared. Results The incidence of small for gestational age(SGA)(80.0% vs 40.0%, χ~2=7.287) and cholestasis(15.0% vs 0.0%, χ~2=4.018) was significantly higher in the PIH group than in the control group. The incidence of respiratory distress syndrome(NRDS), intracranial hemorrhage-white matter lesions, hospitalization time, and mortality were not statistically significant. The use rate of pulmonary surfactant in children with NRDS was significantly lower than that of the control group(40.0% vs 72.7%, χ~2=4.582).Conclusion Pregnancy-induced hypertension in the mother can increase SGA and cholestasis in premature infants with ELBW, but pregnancy-induced hypertension may reduce the severity of NRDS.
Objective To analyze the effect of hypertensive syndrome of pregnancy(PIH) on the complications of preterm low ultra-low birth weight(ELBW). Methods A total of 45 ELBW premature infants were enrolled in the neonatology department of our hospital from February 2012 to May 2017. The children were convenient divided into the pregnancy-induced hypertension group and the control group according to whether they were pregnant or not. Short-term major complication rate and mortality, hospitalization time and other indicators were compared. Results The incidence of small for gestational age(SGA)(80.0% vs 40.0%, χ~2=7.287) and cholestasis(15.0% vs 0.0%, χ~2=4.018) was significantly higher in the PIH group than in the control group. The incidence of respiratory distress syndrome(NRDS), intracranial hemorrhage-white matter lesions, hospitalization time, and mortality were not statistically significant. The use rate of pulmonary surfactant in children with NRDS was significantly lower than that of the control group(40.0% vs 72.7%, χ~2=4.582).Conclusion Pregnancy-induced hypertension in the mother can increase SGA and cholestasis in premature infants with ELBW, but pregnancy-induced hypertension may reduce the severity of NRDS.
引文
[1]徐颂周,胡晓艳,赵方,等.妊高征对极低出生体重早产儿并发症的影响[J].中国当代儿科杂志,2017(4):402-404.
[2]杨春燕,田敏,许平,等.孕母妊娠高血压对早产儿结局影响的临床研究[J].中国儿童保健杂志,2017(9):938-941.
[3]Gemmell L,Martin L,Murphy KE,et al.Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28weeks'gestation[J].J Perinatol,2016,36(12):1067-1072.
[4]胡剑苗,王青.妊娠期高血压疾病及并发症对母婴妊娠结局的影响[J].中国妇幼保健,2017(21):5272-5274.
[5]王淑云,邓有敬,吴莹莹.低出生体重儿的相关因素分析[J]中国妇幼保健,2016(13):2646-2648.
[6]Sharma KJ,Esakoff TF,Guillet A,et al.Pregnancies complicated by both preeclampsia and growth restriction between34 and 37 weeks'gestation are associated with adverse perinatal outcomes[J].J Matern Fetal Neonatal Med,2017,30(19)2342-2345.
[7]Tubman TR,Rollins MD,Patterson C,et al.Increased incidence of respiratory distress syndrome in babies of hypertensive mothers[J].Arch Dis Child,1991,66(1 Spec No):52-54.
[8]Langenveld J,Ravelli AC,van Kaam AH,et al.Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation:a 7 year retrospective analysis of a national registry[J].Am J Obstet Gynecol,2011,205(6):540.e1-7.
[9]Yen TA,Yang HI,Hsieh WS,et al.Preeclampsia and the risk of bronchopulmonary dysplasia in VLBW infants:a population based study[J].PLoS One,2013,8(9):e75168.
[10]林广,潘新年,刘先知.极低出生体重儿非先天性胆汁淤积发病的危险因素分析[J].临床儿科杂志,2009(10):919-921,925.
[11]刘国瑞,麻洁心,毛健,等.极低及超低出生体重儿支气管肺发育不良的影响因素[J].国际儿科学杂志,2018,45(10)794-798.
[12]Guorui L,Jiexin M,Jian M,et al.Influencing factors for bronchopulmonary dysplasia in VLBWI and ELBWI[J].Int J Pediatr,2018,45(10):794-798.
[2]杨春燕,田敏,许平,等.孕母妊娠高血压对早产儿结局影响的临床研究[J].中国儿童保健杂志,2017(9):938-941.
[3]Gemmell L,Martin L,Murphy KE,et al.Hypertensive disorders of pregnancy and outcomes of preterm infants of 24 to 28weeks'gestation[J].J Perinatol,2016,36(12):1067-1072.
[4]胡剑苗,王青.妊娠期高血压疾病及并发症对母婴妊娠结局的影响[J].中国妇幼保健,2017(21):5272-5274.
[5]王淑云,邓有敬,吴莹莹.低出生体重儿的相关因素分析[J]中国妇幼保健,2016(13):2646-2648.
[6]Sharma KJ,Esakoff TF,Guillet A,et al.Pregnancies complicated by both preeclampsia and growth restriction between34 and 37 weeks'gestation are associated with adverse perinatal outcomes[J].J Matern Fetal Neonatal Med,2017,30(19)2342-2345.
[7]Tubman TR,Rollins MD,Patterson C,et al.Increased incidence of respiratory distress syndrome in babies of hypertensive mothers[J].Arch Dis Child,1991,66(1 Spec No):52-54.
[8]Langenveld J,Ravelli AC,van Kaam AH,et al.Neonatal outcome of pregnancies complicated by hypertensive disorders between 34 and 37 weeks of gestation:a 7 year retrospective analysis of a national registry[J].Am J Obstet Gynecol,2011,205(6):540.e1-7.
[9]Yen TA,Yang HI,Hsieh WS,et al.Preeclampsia and the risk of bronchopulmonary dysplasia in VLBW infants:a population based study[J].PLoS One,2013,8(9):e75168.
[10]林广,潘新年,刘先知.极低出生体重儿非先天性胆汁淤积发病的危险因素分析[J].临床儿科杂志,2009(10):919-921,925.
[11]刘国瑞,麻洁心,毛健,等.极低及超低出生体重儿支气管肺发育不良的影响因素[J].国际儿科学杂志,2018,45(10)794-798.
[12]Guorui L,Jiexin M,Jian M,et al.Influencing factors for bronchopulmonary dysplasia in VLBWI and ELBWI[J].Int J Pediatr,2018,45(10):794-798.