486例极低及超低出生体质量儿产科因素分析

Obstetric Factor Analysis of 486 Very Low Birth Weight Infants and Extremely Low Birth Weight Infants

目的探讨极低及超低出生体质量儿的相关产科因素,以降低极低及超低出生体质量儿的出生率。方法回顾性分析486例极低及超低出生体质量儿和427例孕妇的临床资料。结果早产儿占极低及超低出生体质量儿总数的89.51%,胎龄主要集中在28~32周（62.35%）。极低出生体质量儿的比例（84.16%）远远大于超低出生体质量儿（15.84%）。孕妇剖宫产率为68.15%,初产妇占孕妇总数的77.75%。造成极低及超低出生体质量儿的常见产科因素为子痫前期重度、胎膜早破、胎盘早剥、宫颈机能不全、羊水量异常等。结论 28~32周的极低出生体质量儿是产儿科医师工作的重点对象。存在子痫前期重度、胎膜早破、胎盘早剥、宫颈机能不全、羊水量异常等产科因素的初产妇生产极低及超低出生体质量儿的风险较高。

Objective To investigate the obstetric factors related to very low birth weight infants and extremely low birth weight infants,andto reduce the natality of them.Methods Retrospective analysis was done on the clinical data of 486 very low birth weight infants and ex-tremely low birth weight infants and 427 pregnant women,who gave birth to babies between January 2008 and October 2010 in our hospital.Results Among 486 very low birth weight infants and extremely low birth weight infants,89.51% were preterm infants,with gestational agemainly between 28 and 32 weeks.The incidence of very low birth weight infants（84.16%）was larger than that of extremely low birth weightinfants（15.84%）.Among 427 pregnant women,77.75% were primipara,68.15% chose cesarean section.Among many obstetric factors lead-ing to very low birth weight infants and extremely low birth weight infants,severe preeclampsia was most important;premature rupture ofmembrane,placental abruption,cervical incompetence and amniotic fluid abnormality were also important.Conclusion The very low birthweight infants between 28 and 32 weeks were focal points for obstetrician and pediatrician.Primipara with severe preeclampsia,prematurerupture of membrane（PROM）,placental abruption,cervical incompetence or amniotic fluid abnormality had high risk of very low birth weightinfants or extremely low birth weight infants.