新生儿窒息母婴高危因素分析

Analysis on maternal and infantile high risk factors of neonatal asphyxia

目的:分析新生儿窒息母婴高危因素,探讨该地区围产期母婴保健重点。方法:采用回顾性资料分析方法对2009年1～12月该院产科分娩的新生儿窒息母婴高危因素进行统计。结果:该年度产科分娩数9 632人,新生儿窒息157例,窒息发生率1.63%。新生儿窒息患儿均有围产高危因素,其中母亲因素占24.84%,胎儿新生儿因素占66.24%,胎盘脐带因素占25.48%,产时因素占24.84%。新生儿窒息中胎儿新生儿病因占第一位,其中早产儿91例、低出生体重儿85例,其他过期产儿、双胎、巨大儿、先天畸形儿共13例。重度窒息7例,发生率0.07%。孕29周3例,孕35周、体重1 300 g 1例,孕34周、胎盘早剥、脐带过细1例,2例先天畸形(先天性肺发育不良、胸腔积液)患儿。结论:早产儿、低出生体重儿已成为该地区新生儿窒息的首要原因,早产儿复苏应成为复苏培训重点。先天畸形为新生儿重度窒息的主要因素,复苏过程中警惕先天畸形的存在可改善预后、防范医疗纠纷。

Objective：To analyze the maternal and infantile high risk factors of neonatal asphyxia,explore the key point of maternal and infantile health care during perinatal period in the region.Methods：A retrospective analysis was used to statistically analyze the maternal and infantile high risk factors of neonates with asphyxia who were born in obstetrical department of the hospital from January to December in 2009.Results：9 632 neonates were born in obstetrical department of the hospital in 2009,157 neonates were found with asphyxia,the incidence was 1.63%.All the neonates with asphyxia had high risk factors during perinatal period,the proportions of maternal factors,fetal and neonatal factors,placental and umbilical factors and intrapartum factors were 24.84%,66.24%,25.48% and 24.84%,respectively.Fetal and neonatal factors ranked the first among the neonates with asphyxia,including 91 premature infants,85 low birth weight infants and 13 infants of retarded birth,twin pregnancy,macrosomia and congenital malformations.7 neonates were found with severe asphyxia,accounting for 0.07%.3 neonates were born at 29 gestational weeks,1 neonate was born at 35 gestational weeks whose body weight was 1 300 g,1 neonate was born at 34 gestational weeks and found with placental abruption and thin umbilical cord,2 neonates were found with congenital malformations（congenital pulmonary hypoplasia,pleural effusion）.Conclusion：Premature infants and low birth weight infants become to be the principal cause of neonatal asphyxia in the region,resuscitation of premature infants should become the key point of resuscitation training.Congenital malformation is a main factor of severe neonatal asphyxia,watching out for the existence of congenital malformations in the course of resuscitation can improve prognosis and prevent medical disputes.