孕妇胎膜早破对母婴结局和新生儿并发症的影响

Influence of premature rupture of membranes on pregnancy outcome and neonatal complications

目的探讨孕妇胎膜早破对新生儿相关因素的影响。方法研究对象为2010年7月-2011年12月上海市第十人民医院收治的住院分娩的2060例孕妇,其中有胎膜早破者393例设为观察组,无胎膜早破者1667例设为对照组,观察并比较两组母婴结局(包括新生儿评分、母乳喂养率、母乳喂养开始时间)与新生儿并发症(新生儿黄疸、新生儿感染、新生儿窒息)情况。结果观察组新生儿评分[(7.01±1.43)分]、母乳喂养率(57.5%)均显著低于对照组,差异均有统计学意义(均P<0.05);观察组母乳喂养开始时间[(45.38±13.17)h]显著迟于对照组[(31.22±12.05)h],差异有统计学意义(P<0.05);观察组新生儿黄疸发生率为12.9%(51/393),新生儿感染发生率为11.7%(46/393),新生儿窒息发生率为7.6%(30/393),均显著高于对照组[3.5%(58/1667)、2.6%(43/1667)、1.9%(15/1667)],差异均有统计学意义(均P<0.05)。结论孕妇胎膜早破是产科常见的、多发的并发症,是导致围生儿死亡的重要因素,需要积极预防,及时采取合理措施,以保障母婴安全,且新生儿并发症应积极治疗。

Objective To explore in pregnant women with premature rupture of membranes on related factor of neonatal influence. Methods 2060 cases of pregnant women from July 2010 to December 2011 in our hospital were selected and divided into two groups, 393 cases with premature rupture of membranes were seen as the observation group, 1667 eases without premature rupture of membranes were seen as the control group. The pregnancy outcome including neonatal score, breast feeding rate, breastfeeding start time and neonatal complications （neonatal infection, neonatal jaundice, neonatal asphyxia） were observed and compared. Results Neonatal score of observation group was （7.01± 1.43） scores, breast feeding rate of observation group was 57.5%, the two indexes were all lower than those of control group, the differences were all statistically significant （P 〈 0.05）; breasffeeding start time of observation group was （45.38±13.17） h, it was later than that of control group, the difference was statistically significant （P 〈 0.05）; the occurrence rate of neonatal jaundice of observation group was 12.9% （51/393）, neonatal infection was 11.7% （46/393）, neonatal asphyxia was 7.6% （30/393）, they were all higher than those of control group [3.5% （58/1667）, 2.6% （43/1 667）, 1.9% （15/1667）], the differences were all statistically significant （all P 〈 0.05）. Conclusion Maternal premature rupture of fetal membranes is a common obstetric, multiple complications, perinatal death is an important risk factor, it is right to take active prevention, timely and proper measures to ensure the safety, active treatment and neonatal complications.