胎膜早破与足月新生儿呼吸窘迫综合征的相关分析

Correlation Analysis of Premature Rupture of Membranes and Term Neonates with Respiratory Distress Syndrome

目的明确胎膜早破(PROM)与足月新生儿呼吸窘迫综合征(RDS)的相关性。方法采用病例对照研究的方法,选择2008年1月-2010年12月出生后在本院新生儿重症监护中心住院、胎龄在37周以上、诊断为RDS的患儿205例为病例组,同期入院、主要诊断为新生儿黄疸(除外感染因素所致者)的410例足月新生儿为对照组。对所有纳入对象的临床资料进行回顾性分析,记录相关信息,包括有无PROM、患儿性别、分娩方式、出生体质量、羊水污染等,探讨PROM与足月儿RDS的关系。结果 1.RDS组RPOM所占比例(30.2%,62/205例)明显高于对照组(15.5%,63/410例),差异有统计学意义(χ2=12.276,P<0.001)。2.经单因素分析,PROM、选择性剖宫产、男性、小于胎龄儿、羊水量少、妊娠期血糖偏高及糖尿病、羊水Ⅲ度污染、宫内窘迫、出生时窒息等因素均与足月儿RDS具有相关性(Pa<0.05),均为RDS的危险因素,而孕母年龄≥35岁、脐带绕颈、胎盘早剥与RDS均无相关性(Pa>0.05)。3.经Logistic回归分析:PROM、选择性剖宫产、男性、妊娠期血糖异常及糖尿病、出生时窒息等与足月儿RDS密切相关。结论 PROM与足月儿RDS密切相关,是足月儿RDS的高危因素之一。

Objective To investigate the correlation between premature rupture of membranes（PROM） and respiratory distress syndrome（RDS） in full-term neonates. Methods From Jan.2008 to Dec.2010,a total of 205 full-term newborns with RDS were included in the study group who were administrated in the Department of Neonatology NICU,Bayi Children′s Hospital Affiliated to General Hospital of Beijing Military Command.At the same periods,410 full-term neonates without RDS were assigned as control group.The clinical information including the presence or absence of PROM,gender of the babies,mode of delivery,birth weight,and any conditions suffered by the infants,etc.were recorded to compare their difference between 2 groups. Results 1.The incidence rate of PROM was 30.2%（62/205 cases） in RDS patients,which was higher than that in control group（15.5%,63/410 cases）（χ2=12.276,P0.001）.2.Univariate analysis showed that PROM,selective cesarean section,male,low birth weight,oligohydramnion,meconium staining of amniotic fluid,severe fetal distress and birth asphyxia were the main risk factors of full-term neonatal RDS（Pa0.05）.Maternal age ≥35 years of age,cord around neck,placental abruption had no correlation with RDS,the differences were not statistically significant（Pa0.05）.3.The Logistic regression analysis showed that PROM,selective cesarean section,male,low birth weight,gestational glucose abnormalities and diabetes mellitus,and birth asphyxia were closely correlated with RDS in full-term newborns. Conclusion PROM is closely correlated with RDS in full-term neonates,this finding is significant for the clinical management of RDS in term newborns.