广东省新生儿窒息发病率调查及危险因素分析

Incidence and risk factor analysis of neonatal apnea in the representative regions of Guangdong Province

目的了解广东省新生儿窒息的发病率及其流行特征,分析有关危险因素。方法以整群抽样的方式收集资料,用多因素Logistic回归分析筛选危险因素。结果广东地区新生儿窒息发病率为9.85%。产妇心脏病、贫血、流产次数、胎位及先露因素、催产素、胎头吸引、第二产程延长、剖宫产次数为新生儿窒息发病的危险因素,怀孕次数、接近分娩的最后一次产检以及较高等级的产检医院及分娩医院、产检次数为新生儿窒息发病的保护因素。羊水不正常、早产、脐带绕颈为新生儿窒息发病的胎儿危险因素,正常合适的羊水量为新生儿窒息发病的保护因素。结论避免危险因素,关注保护因素,以减少和预防新生儿窒息的发病。

Objective To conduct an epidemiological survey of the prevalence of neonatal apnoea and and identify its risk factors in Guangdong Province. Methods The epidemiological data of neonatal apnea were collected by means of cluster sampling from 10 representative regions of Gunagdong Province, and the risk factors for this condition were analyzed with logistic regression. Results In the representative regions chosen for this survey, the incidence of neonatal apnea was 9.85% in the newborn infants, suggesting a generally similar picture of its prevelance in Guangdong Province. Materanl heart disease and anaemia, number of miscarriages, fetal position and present, oxytocin application, vacuum extraction, prolonged second stage of labor, and number of cesarean delivery were identified as the risk factors for neonatal apnoea, whereas number of pregnancies, the last antenatal examination prior to delivery, high-level antenatal examination hospital, antenatal examination times, and number of normal deliveries were the protective factors. Abnormal amniotic fluid, premature birth, and cord around the neck were the most important risk factors for neonatal apnoea, and adequate amniotic fluid volume is the protective factors for neonatal apnoea. Conclusion Rigorous control of the risk factors and enhancement of the protective factors can reduce or even prevent the incidence of neonatal apnoea.