新生儿呼吸窘迫综合征发病相关因素分析

Multivariate analysis of perionetal influence factors associated with neonatal respiratory distress syndrome

目的探讨与新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)发生相关的因素,从而为降低NRDS发病率提供临床资料。方法2011年1月-2014年3月期间选择在本院新生儿科出生并被诊断为NRDS的70例患儿作为病例组,按1∶1.2的比例收集同期出生的84例非NRDS新生儿作为对照组。回顾性收集病例组与对照组新生儿的相关临床资料,并进行单因素和Logistic回归分析。结果 1)单因素分析结果:病例组孕妇年龄和男性、宫内感染、选择性剖宫产、羊水吸入、宫内窘迫与产时窒息的比例均高于对照组(P<0.05);患儿胎龄和产前使用激素的比例低于对照组的值(P<0.05);2)Logistic回归分析结果:产时窒息(OR=11.3,P=0.025)、出生体重<2 500g(OR=10.2,P=0.004)、选择性剖宫产(OR=6.2,P=0.002)、性别(OR=3.7,P=0.04)和孕妇年龄(岁)(OR=1.7,P<0.001)是NRDS的独立危险因素;而胎龄(周)(OR=0.6,P=0.002)和产前使用激素(OR=0.1,P<0.001)则是NRDS的独立保护因素。结论孕妇年龄、低出生体重、男性、选择性剖宫产和产时窒息能增加NRDS发生的风险;而长胎龄和产前使用激素能降低NRDS的发生风险。

Objective To explore influence factors associate with neonatal respiratory distress syndrome（NRDS）.Methods A total of 70 NRDS cases were selected as observation group,while 84 neonates without NRDS borned during corresponding period were selected as control group.Perinatal clinical data were collected and analyzed. Results 1）One way analysis showed age of pregnant women and proportion of male,intrauterine infection,selective caesarean section,amniotic fluid aspiration,in utero distress and intrapartum asphyxia in observation group were significantly greater than those in control group（P〈0.05）,while gestational age and proportion of antenatal corticosteroids were significantly lower than those in control group（P〈0.05）.2）Logistic regression analysis showed age of pregnant women（OR=1.7,P〈0.001）and proportion of low birth weight（OR=10.2,P=0.004）,male（OR=3.7,P=0.04）,selective caesarean section（OR=6.2,P=0.002）,and intrapartum asphyxia（OR=11.3,P=0.025）were independent risk factors for NRDS,while gestational age（OR=0.6,P=0.002）and proportion of antenatal corticosteroids（OR=0.1,P〈0.001）were independent protective factors. Conclusion Age of pregnant women and low birth weight,male,selective caesarean section,and intrapartum asphyxia can increase the risk of NRDS,while gestational age and antenatal corticosteroids can reduce the risk of NRDS.