新生儿体重下降与分娩期产妇输液量的相关性探讨

Relationship between the transfusion of women receiving during parturition and their newborn's weight loss

目的:探讨产妇在分娩过程中的输液量与新生儿产后72 h内体重下降的相关性。方法:记录109名产妇分娩过程中经口以及经静脉的液体入量,在产后3天内每隔12 h测量新生儿体重,此后每天测1次至第14天;此外还需要称量新生儿3天的排出量(大小便)。结果:96例出生后60 h新生儿的平均体重下降(6.57±2.51)%;根据产妇输液量进行分组之后两组比较,低输液量组(≤1 200 ml)新生儿体重下降5.51%,高输液量组(>1 200 ml)新生儿体重下降6.93%,差异有统计学意义(P=0.03)。在第24 h新生儿排出量与新生儿体重下降百分比正相关(P<0.001),分娩期间最后2 h产妇输液量与新生儿排出量正相关(P=0.012),在第72 h新生儿体重下降重量与产妇总输液量正相关(P=0.007)。结论:产妇静脉输液时间及输液量与新生儿排出量及体重下降相关。新生儿在出生后24 h内通过排尿调节体内的液体状态,因此建议衡量新生儿体重改变的基础体重在出生后24 h测量而不是使用出生时体重。

Objective： To explore the relationship between the intravenous transfusion of women receiving during parturition and their newborn weight loss during the first 72 hours postpartum. Methods： Data about maternal oral and intravenous transfusion during labour or before a caesarean section were collected. Newborns of participants （n = 109） were weighed every 12 hours for the first three days then once a day to the 14th day, and the neonatal output （voids and stools） for three days were weighed. Results： At 60 hours after birth, mean newborn weight loss of 96 cases was 6. 57% ± 2. 51% （n = 96） . Mean newborn weight loss of low transfusion group （≤ 1 200 ml , n =-21 ） was 5.51% , mean newborn weight loss of high transfusion group （ 〉 1 200 ml, n = 53 ） was 6. 93% , there was significant difference （ P 〈 0. 05） . There were positive relationships between a neonatal output and percentage of newborn weight lost on the first 24 h [ r （96） = 0. 493, P 〈 0. 0013, between maternal intravenous transfusion on final 2 hours during delivery and neonatal output [ r （42） = 0. 383, P 〈 0. 053, between grams of weight lost and all maternal transfusion on 72 h [ r （ 75 ） = 0. 309, P 〈 0. 01 3 . Conclusion ： Timing and amounts of maternal transfusion appear correlated to neonatal output and newborn weight loss. Neonates appear to experience diuresis and cor-rect their fluid status on the first 24 hours. A measurement at 24 hours is recommend, instead of birth weight, for baseline when assessing weight change.