低出生体重儿高危因素分析

Analysis of high-risk factors of low birth weight infant

目的探讨低出生体重儿（LBWI）发生的病因及相关并发症,为减少其发生率,提高并发症的防治能力,降低病死率提供临床资料。方法收集2008年7-12月及2005年同期我院新生儿科住院LBWI的临床资料,按住院年份分为2008年和2005年两组,将住院LBWI共325例按孕周分为4组,即≤32周、33-34周、35~36周、≥37周,按出生体重分为两组,即〈1500g和1500-2499g。对其发生原因,并发症及病死率进行比较。结果LBWI主要发生于早产,妊娠期高血压疾病,胎膜早破及多胎妊娠是其主要原因,且多胎妊娠、高龄产妇和多次流产所占比例2008年较2005年高P〈0.05,出生体重越低病死率及新生儿呼吸窘迫综合征（NRDS）、呼吸暂停、重症感染、颅内出血、硬肿的发生率越高,P〈0.05。胎龄越小,新生儿呼吸窘迫综合征、呼吸暂停、颅内出血、硬肿发生率及病死率越高,4组比较P〈0.05。2008年与2005年同期比较,LBWI的重症感染及硬肿发生率降低,P〈0.05。呼吸窘迫综合征、动脉导管未闭（PDA）、颅内出血、呼吸暂停的发生率比较差异无统计学意义,P〉0.05。结论尽量避免高龄孕产和多次流产,同时加强高危孕妇围产期监测,减少LBWI发生概率,对LBWI应积极预防各种并发症,并针对性治疗,以降低其病死率。

Objective To study the etiology low birth weight infant（LBWI）and their complications in order to provide clinical data for decrease their incidence rate,improving the ability of prevention and treatment in their complications and reducing their mortality rate.Methods The LBWI born in hospital from July to December in 2008 and in 2005 were assigned into two groups according to the years they were born,year 2008 and year 2005;they were also divided into four groups according to their gestational age,not more than 32 weeks,33 to 34 weeks,35 to 36 weeks and full-term infant;two groups according to their weight,less than 1500 grams,1500 to 2499 grams.The data of the etiologies,their complications and mortality rate were analyzed and compared.Results The study showed that most LBWI were premature and the causes for it were pregnancy-induced hypertension syndrome（PIH）,premature rupture of membranes and multiple pregnancies.The rate of multiple pregnancies,high maternal age and multiple abortion was significantly higher in group of year 2008 than in group of 2005（P〈0.05）.It was found that the lower the birth weight of infant,the higher their hospital mortality rate and their complications（NRDS,apnea,sever infection,intracranial hemorrhage,scleredema）were（P〈0.05）.The smaller the gestational age of infant,the higher their complications（NRDS,apnea,intracranial hemorrhage,scleredema）and their mortality rate were（P〈0.05）.It was also found that the incidence of severe infection,scleredema in year 2008 was reduced compared with in 2005（P〈0.05）,the incidence of neonatal respiratory distress syndrome（NRDS）,patent ductus arteriosus（PDA）,intracranial hemorrhage and apnea were not statistically significant（P〉0.05）,between the groups of year 2008 and year 2005.Conclusion To lower the incidence of LBWI,we should avoid the incidence of the high maternal age and multiple abortion as soon as possible,also monitor the high risk pregnant women closely during pregnancy period,prevent and treat all kinds of complication to reduce the mortality rate.