中国城市早产儿流行病学初步调查报告

An initial epidemiologic investigation of preterm infants in cities of China

目的 通过对我国较大范围的早产儿流行病学调查,提供有关我国的早产儿资料,也为今后更大 规模的全国新生儿流行病学调查奠定基础。方法 对16个省、自治区、直辖市的77所城市医院2002～2003年 6179名早产儿的高危因素、并发症、转归情况进行回顾性调查。结果 产科出生的新生儿中早产儿发生率为 7.8%,新生儿科住院病人中早产儿占19.7%,男女之比为1.67∶1。胎龄32～36周占63.5%。出生体重<1500g 占32.3%。早产儿的高危因素依次为母亲流产史(36.8%),多胎(20.1%),胎膜早破(19.8%)和妊高症 (12.6%)。并发症的发生率依次为:呼吸系统疾病(52.3%),中枢神经系统疾病(33.7%),高胆红素血症 (22.6%),感染性疾病(12.0%),消化系统疾病(10.6%)和循环系统(9.0%)。随胎龄和/或体重增加,总体并发 症发生率呈下降趋势(P<0.001);除缺氧缺血性脑病(HIE)发生率没有随胎龄增加而下降外,其他并发症发生率 均随胎龄增加而逐渐下降(P<0.001)。治愈好转率随早产儿胎龄和体重的增加呈增加趋势(P<0.001)。结论 该调查揭示了早产儿发生的常见原因以及影响早产儿转归的因素,为降低早产儿的发生率和改善早产儿预后提供 了理论依据。

Objective In order to establish a foundation for further epidemiological survey of preterm infants throughout China, this paper collected and analyzed medical documents of premature infants from some cities of China. Methods A total of 6 179 preterm infants from 77 hospitals in 16 provinces, municipalities or direct jurisdiction cities in China between January 2002 and December 2003 were enrolled in this study. High risk factors and complications associated with premature birth and incidence and outcome of premature infants were investigated retrospectively.Results The incidence of the preterm infant was 7.8% in neonates born in the department of obstetrics, accounting for 19.7% in hospitalization neonates and with a gender constituent ration of 1.67∶1 (boy∶girl). The preterm infants born at gestational age between 32-36 weeks accounted for 63.5% and those with body weights less than 1 500 g accounted for 32.3% in all premature infants. The most common precipitating factor of premature birth was the abortion history of the mother ( 36.8%), followed by multifetation ( 20.8%),premature rupture of membranes ( 19.8%) and pregnancy-induced hypertension syndrome (12.6%). The most common complication was respiratory system diseases (52.3%), followed by central nervous system disease (33.7%), hyperbilirubinemia (22.6%) and infectious diseases (11.3%),digestive system diseases(10.6%) and circulation system diseases (9.0%). The incidence of complications decreased with the increase of body weight. With the increase of gestational age, a significant decrease in the incidence of complications except hypoxia-ischemic encephalopathy(HIE) was also observed. The desirable outcome of the premature infant rose with the increase of gestational age or body weight.Conclusions The investigation demonstrated the common causes of premature birth and the factors related to the outcome of the premature infant. It provides a basis for decreasing the incidence and improving the prognosis of the premature infant.