广州市部分地区早产病因及早产儿结局分析

Investigation of preterm birth and preterm infants in Guangzhou regional district

目的探讨广州部分地区医院近6年早产发生情况及不同孕周、不同早产原因新生儿结局。方法选择2005年1月～2010年12月在广州市花都区人民医院产科、南方医科大学南方医院住院并分娩的早产孕妇997例及1138例早产儿为研究对象,分析统计该部分孕妇的临床特征及母儿围产结局。结果 (1)早产发生率及构成比:6年的早产的发生率为10.6%(997/9395)。在早产的发生原因排序中,PPROM早产占首位(41.3%,412/997),其次为医源性早产(34.8%,347/997)和自发性早产(23.9%,238/997)。医源性早产中主要原因分别是子痫前期154例(44.4%,154/347),前置胎盘72例(20.7%,72/347),胎儿窘迫62例(17.9%,62/347),胎盘早剥34例(9.8%,34/347)以及妊娠合并内外科疾病25例(7.2%,25/347)。(2)不同孕周与早产儿结局:<32周的早产儿并发症发生率与死亡率明显高于32～34周和≥34周早产儿(P<0.05)。≥34周早产儿治愈率最高,并发症发生率与死亡率明显低于其他两组(P<0.05)。(3)不同原因与早产儿结局:自发性早产治愈率最高、早产儿并发症发生率最低,与其他两组相比差异有统计学意义(P<0.05)。医源性早产的早产儿死亡率最高,与其他两组相比差异有统计学意义(P<0.05)。PPROM早产儿并发症发生率最高,与其他两组相比差异有统计学意义(P<0.05)。结论 <32孕周的早产儿并发症发生率和死亡率较高,这部分早产儿是早产预防的重点;同时,加强孕前检查和规律孕期产检,及时发现妊娠期并发症,减少医源性早产、PPROM早产的发生。

Objective To investigate the incidence and relevant data of preterm birth and the outcomes of preterm infants delivered at different gestational weeks and for different causes. Methods A total of 997 women with preterm delivery in Huadu People＇s Hospital and Nanfang Hospital their 1 138 neonates of the previous mothers were enrolled as the research object in this survey from January 2005 to December 2010. The clinical features, maternal and neonatal outcomes were analyzed. Results （1） The incidence and constitute a premature than： six years of premature birth occurred in 10.6% （997/ 9 395）. In the cause of premature birth order, PPROM of premature birth first （41.3%, 412/997）, the second was iatrogenic preterm （34.8%, 347/997） and spontaneous preterm （23.9%, 238/997）. Cure source sex in premature main reason were preeclamp- sia in 154 cases （44.4%, 154/347）, lead the placenta in 72 cases （20.7%, 72/347）, fetal distress in 62 cases （17.9%, 62/ 347）, abruption in 34 cases （9.8%, 34/347） and pregnancy with function mostly the function of 25 cases of disease （7.2%, 25/347）. （2） Pregnant weeks premature end with different： 〈32 weeks premature mortality and complications of significantly higher than 32 to 34 weeks and frequency 34 weeks premature infants （P 〈 0.05）. Quartile 34 weeks premature cure rate was high, complications and death rate was significantly lower than the other two groups （P 〈 0.05）. （3） Different reasons and premature end： spontaneous preterm premature complications, the highest rate in the lowest, and the difference was statistical significance than other two groups （P 〈 0.05）. Iatrogenic preterm premature deaths, and the difference was statistical significance than other two groups （P 〈 0.05）. PPROM premature complications supreme, and the difference was statis- tical significance than other two groups （P 〈 0.05）. Conclusion Preterm birth before 32 weeks is associated with high peri natal mortality rate, which would be highlighted in prevention. Improved the prenatal care and antenatal care and timely detection of pregnancy complications should be implemented. Reduction of the iatrogenic preterm birth and proper prevention of PPROM are imnortant measurements in decreasinu the nrevalence of nreterm birth.