孕34-36^(+6)周胎膜早破母儿预后的影响因素

Factors on matemal and fetal outcomes of pregnancy complicated with premature rupture of membrane between 34 and 36^(+6) weeks' gestation

目的研究妊娠34-36^(+6)周胎膜早破妇女及其新生儿预后的影响因素。方法对孕34-36^(+6)周胎膜早破者按是否合并绒毛膜羊膜炎分组。统计产妇年龄,产次,破水孕周,破水至分娩时间间隔,产前激素、抗生素治疗情况,产前白细胞计数,分娩方式,新生儿性别、体重、收住院情况,分析新生儿住院的影响因素。结果 56例妊娠34-36^(+6)周胎膜早破妇女中绒毛膜羊膜炎发生率为10.7%。合并绒毛膜羊膜炎组的新生儿住院率与无绒毛膜羊膜炎组的相比有显著差异(P=0.034)。剖宫产率、产后住院日、新生儿的体重、性别、新生儿窒息的发生率在2组间无显著差异。Logistic同归分析提示,新生儿体重为新生儿住院的有效白变量(P=0.035)。结论妊娠34-36^(+6)周的胎膜早破妇女合并绒毛膜羊膜炎和低出生体重是新生儿住院治疗的风险因素。

Objective： To study the factors on maternal and fetal outcomes of pregnancy complicated with premature rupture of membrane between 34 and 36 ＋6 weeks＇gestation. Methods： We did a retrospective research on 56 women with premature rupture of membrane between 34 and 36^＋6 weeks＇ gestation. They were categorized into 2 groups according to the presence of chorioanmionitis. The outcome measures were cesarean section rate, chorioamnionitis, postpartum hospital stay, Apgar score and NICU admission. Resuits： Chorioamnionitis complicates pregnancy for 10. 7% of women with PROM between 34 and 36^＋6 weeks＇ gestation. NICU admission rate is significantly higher in the group complicated with chorioamnionitis （ P = 0. 034）. There is no statistical difference in cesarean section rate, postpartum hospital stay, birth weight, gender and Apgar score between 2 groups. Logistic regression indicates that low birth weight is correlated with NICU admission. Conclusion： In women with PROM between 34 and 36^＋6 weeks＇ gestation, chorioamnionitis and low birth weight are risk factors of NICU admission.