羊水粪染新生儿结局情况及影响因素分析

Analysis of the Outcome and Influencing Factors of Newborns with Meconium-stained Amniotic Fluid

目的研究与羊水粪染相关的危险因素,及其对新生儿结局的影响。方法选取2018年4月至2019年9月期间在本院分娩的80例羊水粪染单胎孕产妇作为观察组研究对象,另选同期80例羊水正常孕产妇纳入对照组,研究160例新生儿结局,以及与羊水粪染相关的危险因素。结果观察组发生新生儿窒息11例(13.75%)、胎粪吸入综合征6例(7.5%)、缺血性脑病3例(3.75%)、其它肺部疾病3例(3.75%),总发生率(28.75%)明显高于对照组(7.5%),P=0.0004;单因素分析得出与羊水粪染相关因素主要有过期产、胎膜早破、羊水过少、脐带异常、子痫前期(P1=0.0003,P2=0.0001,P3=0.0005,P4=0.0010,P5=0.0163);经Logistic回归模型分析得出,上述因素均可列为独立高危因素(OR1=3.9002,OR2=3.7452,OR3=4.2815,OR4=3.5869,OR5=2.7865,P1=0.0001,P2=0.0001,P3=0.0001,P4=0.0006,P5=0.0014)。结论羊水粪染易导致新生儿窒息、胎粪吸入综合征、缺血性脑疾病,以及其它肺部疾病发生,且出现时间越早,发生不良结局几率越高,与之相关的危险因素主要包括过期产、胎膜早破、羊水过少等。

Objective To study the risk factors related to meconium-stained amniotic fluid and its effect on neonatal outcome.Methods 80 singleton pregnant women with meconium stained amniotic fluid delivered in our hospital from April 2018 to September 2019 were selected as the observation group,and 80 normal pregnant women with amniotic fluid in the same period were selected as the control group to study the neonatal outcome of 160 cases.and the risk factors associated with meconium-stained amniotic fluid.Results In the observation group,there were 11 cases of neonatal asphyxia(13.75%),6 cases of aspiration pneumonia(7.5%),3 cases of ischemic encephalopathy(3.75%)and 3 cases of other pulmonary diseases(3.75%).The total incidence(28.75%)was significantly higher than that in the control group(7.5%).Univariate analysis showed that the main factors related to meconium staining of amniotic fluid were overdue delivery,premature rupture of membranes,amniotic fluid deficiency,umbilical cord abnormality and eclampsia(P1=0.0003,P2=0.0001,P3=0.0005,P4=0.0010,P5=0.0163).According to the analysis of Logistic regression model,all the above factors could be classified as independent high risk factors(OR1=3.9002,OR2=3.7452,OR3=4.2815,OR4=3.5869,OR5=2.7865).The above factors could be classified as independent high risk factors(P1=0.0001,P2=0.0001,P3=0.0001,P4=0.0006,P5=0.0014).Conclusion Meconium-stained amniotic fluid can easily lead to neonatal asphyxia,aspiration pneumonia,ischemic brain disease and other lung diseases,and the earlier it occurs,the higher the probability of adverse outcome.The related risk factors include overdue delivery,premature rupture of membranes,amniotic fluid deficiency and so on.