新生儿窒息产前高危因素分析

Analysis of Risk Factors of Neonatal Asphyxia in Prenatal

目的:分析新生儿窒息产前高危因素,寻求降低窒息发生率的临床对策。方法:回顾性分析2005年6月至2006年6月出生的168例新生儿窒息患儿的临床资料。随机抽取200例非窒息新生儿进行对照。结果:(1)5620例活产新生儿中窒息的发生率2.99%,窒息儿中产前高危因素依次为胎心异常(增快、减慢)、羊水异常(胎粪污染、过多、过少)、各种原因剖宫产、脐带问题(脱垂、绕颈、扭转、受压、过短)、母贫血、早产、胎膜早破、母患ICP、头盆不称、臀位或其他异常先露、胎盘异常(前置、早剥等)等等。(2)前10位产前高危因素窒息组与非窒息组(对照组)对照比较,其中胎心异常、羊水异常、早产3因素两组间有非常显著性差异(P<0.001)。结论:新生儿窒息的发生是多因素的;产前高危因素可在产前提供预警,但不意味一定发生窒息;胎心异常和羊水异常与窒息的发生密切相关。

Objective：To study the high risk obstetrical,factors of neonatal asphyxia in pre-natal and search for the clinical methods of prevention to reduce the incidence of neonatal asphyxia.Methods：Clinical data of 5620 neonatal cases delivered in the hospital from 2005.06-2006.06 were analyzed retrospectively,and 168 cases with neonatal asphyxia and 200 without neonatal asphyxia were extracted for comparison research.Results：（1）The ratio of neonatal asphyxia in 5620 neonatal cases is 2.99%.The risk factors of neonatal asphyxia in turn were abnormal fetal heart（fast or slow）oligohydramnio（meconium staining of the amniotic fluid,hypoamnio or hyperamnio）,previous cesarean section of all kinds,umbilical cord problem（prolapse,around the neck of fetus,reversed,oppressed or too short）,anemia of mother,premature delivery,PROM,the mother suffering from ICP,Cephalopelvie disproportion,breech delivery or other abnormal fetal position,placentat abnormality（previa,abruption）and so on.（2）Abnormal fetal heart,oligohydramnio,premature delivery posses extremely significant difference（P〈0.001）between the group with asphyxia and the one without asphyxia when the first 10 factors of the two group are compared.Conclusion：Neonatal asphyxia are caused by a lot factors.High risk factors of neonatal asphyxia in pre-natal may provide the early warning,but it doesn＇t necessarily lead to neonatal asphyxia.Abnormal fetal heart and oligohydramnio are significantly relevant to the occurrence of neonatal asphyxia.