足月新生儿急性呼吸窘迫综合征高危因素分析

Logistic regression analysis of high risk factors of acute respiratory distress syndrome in full-term newborns

目的探讨引起足月新生儿急性呼吸窘迫综合征(ARDS)的高危因素,以期为临床防治提供参考。方法收集176例ARDS足月新生儿病历资料,以1∶1比例随机抽取产科分娩足月正常新生儿病历资料,分析引起新生儿ARDS的相关因素。结果足月新生儿ARDS的发生与分娩方式、社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入有关(P<0.05或P<0.01),与新生儿性别、分娩孕周、胎位、脐绕颈无关(P>0.05);非条件多因素Logistic回归分析结果显示,社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入是引起足月新生儿ARDS的独立危险因素(P<0.05或P<0.01)。结论引起足月新生儿ARDS的高危因素主要为社会因素剖宫产、胎儿宫内窘迫、新生儿窒息、羊水吸入,应采取有针对性的措施加以预防。

Objective To investigate the risk factors of acute respiratory distress syndrome（ ARDS） in full-term newborns,in order to provide references for clinical prevention and treatment. Methods Medical records of 176 full-term newborns with ARDS were discussed and obstetric delivery records of normal full-term newborns were selected randomly with 1∶ 1 proportion,analysis of factors as- sociated with neonatal ARDS was made. Results ARDS in full-term newborns was associated with the way of giving birth,cesarean section of social factors,fetal distress and neonatal asphyxia,and amniotic fluid intake（ P ＆lt; 0. 05 or P ＆lt; 0. 01）,but not with the gender of the newborns,delivery gestational age,fetus position,and umbilical cord around neck（ P ＆gt; 0. 05）. Unconditioned multiariable Logis- tic regression analysis results show that the cesarean section of social factors,fetal distress,neonatal asphyxia,amniotic fluid intake were is independent risk factor of ARDS in full-term newborns（ P ＆lt; 0. 05 or P ＆lt; 0. 01）. Conclusion The major risk factors of ARDS in full-term newborns are cesarean section of social factors,fetal distress,neonatal asphyxia,and amniotic fluid intake. Clinicians should take appropriate measures in prevention and treatment.