某三甲医院930例早产回顾性分析

Clinical analysis of 930 cases of preterm birth in a third A hospital

目的探讨不同孕周早产发生率、相关因素、分娩方式、早产儿出生体质量、新生儿窒息的变化,寻求改善早产转归的临床策略。方法搜集2011-01至2014-12在北京军区总医院住院分娩11 142例孕妇资料,其中早产病例930例,分析不同孕周早产(极早期、早期、中期、晚期早产)发生率、相关因素、母儿结局。结果接诊孕妇的早产发生率为8.35%。胎膜早破是不同孕周早产的首位危险因素,4年发生率依次为36.4%、53.9%、47.2%和39.0%;贫血、妊娠期高血糖在极早期早产、早期早产的发生率较高。4年内早产组中剖宫产率为67.7%;新生儿窒息率随孕周增加显著降低(P<0.05)、新生儿体重随孕周增加显著增加(P<0.05)。结论胎膜早破是早产的主要危险因素,应重视孕早期贫血、高血糖的筛查及治疗。

Objective To study the variation tendency of the rate of premature birth,preterm-related factors,mode of delivery,premature child birth weight and neonatal asphyxia in different gestational weeks,in an effort to reduce the incidence of preterm birth and improve the perinatal outcomes. Methods Data of 11 142 hospital delivery cases in General Hospital of Beijing Military command from January 2011 to December 2014 were collected. There were 930 cases of premature birth. Statistical analysis was performed of the tendency,the preterm-related factors,mode of delivery and the neonatal asphyxia in different gestational weeks of prematurity（ very early preterm,early preterm,interim preterm,late preterm）. Results In the four years,the rate of preterm birth was 8. 35%.The four years premature birth incidence was 8. 35%. Premature rupture of membranes was the first risk factor of different gestational weeks premature,the incidence in the order of 42. 8%,36. 4%,53. 9%,47. 2%,39. 0%. Anemia,high blood sugar during pregnancy in the very early and early preterm had a high incidence. In the four years,the rate of the whole preterm cesarean section was67. 7%. The rate of neonatal asphyxia significantly decreased with the increase of gestational age,and the weight of the newborn increased significantly with the increase of gestational age（ P 〈0. 05）. Conclusions Premature rupture of membranes is the first risk factor. We should attach great importance to screening and treatment of anemia and high blood sugar in the early pregnancy.