3611例不同类型单胎早产的临床分析

Clinical analysis of 3611 cases of different types of singleton preterm birth

目的探讨不同类型早产母儿情况的区别。方法回顾性分析单胎早产共3 611例,根据3种不同类型,分为自发性早产(SPB)组1 191例、胎膜早破性早产(PPROM)1 564例及医源性早产(IPD)856例。比较3组产妇的一般情况、地塞米松(DXM)的使用、分娩方式、新生儿出生情况、主要并发症的发生率及结局。结果 SPB组产妇年龄>PPROM组,但<IPD组(P<0.01);SPB组孕次及产次均>PPROM组和IPD组(P<0.05);SPB组、IPD组特殊病史均多于PPROM组(P<0.01);地塞米松使用情况,SPB组<PPROM组和IPD组(P<0.01)。剖宫产率IPD组明显>SPB组和PPROM组(P<0.01)。SPB组、PPROM组新生儿出生体重均>IPD组(P<0.05)。新生儿不良结局SPB组、PPROM组均<IPD组(P<0.05)。PPROM组新生儿呼吸窘迫综合症(NRDS)发生率小于SPB组和IPD组(P<0.05),IPD组吸入综合症发生率>SPB组和PPROM组(P<0.01);PPROM组肺炎、败血症、黄疸发生率>SPB组和IPD组(P<0.05);IPD组颅内出血发生率<SPB组和PPROM组(P<0.05)。结论不同类型早产的产妇情况和围生儿的发病情况及结局差异有统计学意义(P<0.05)。

Objective To explore the difference between different types of preterm birth. Methods Retrospective analysis of 3 611 singleton preterm birth cases was performed. Three different types were divided ： spontaneous preterm birth （ SPB ） group, 1 191 eases ; preterm premature rupture of membranes （PPROM） group, 1 564 eases ; and iatrogenic preterm labor （IPD） group, 856 cases. General situation, use of dexamethasone （ DXM）, mode of delivery, birth status, incidence of major complications and outcome of newborns were compared among the three groups. Results Maternal age of SPB group was older than that of PPROM group,but lower than that of IPD group,P〈0. 01. Group SPB,gravidity and parity were higher than PPROM group and IPD group, P〈O. 05. The number of eases with special history in SPB group, IPD group were more than that in PPROM group,P〈0. 01. The number of dexamethasone used in SPB group was more than that in PPROM group and IPD group,P〈0. 01. The cesarean section rate in IPD was higher than that in SPB group and PPROM group,P〈0. 01. Neonatal birth weight of SPB group and PPROM group were higher than that in IPD group,P〈0. 05. Neonatal Adverse outcome in SPB group and PPROM group were less than that in IPD group,P〈O. 05. Neonatal respiratory distress syndrome （NRDS） incidence in PPROM group were less than SPB group and IPD group,P〈O. 05. Aspiration syndrome incidence in IPD group was more than SPB group and PPROM group,P〈0. 01. Pneumonia, septicemia, and jaundice incidence in PPROM group were higher than that in SPB group and IPD group,P〈0. 05. Intracranial hemorrhage incidence in IPD group was less than SPB group and PPROM group,P〈0. 05. Conclusion In different types of preterm birth,the situation of both perinatal maternal and child＇s case incidence, and the outcome of porinatal children were different.