HBV感染母亲妊娠期低蛋白血症对母婴影响的相关分析

Effect of hypoalbuminemia in pregnant women with HBV infection on themselves and their babies

目的探讨乙肝病毒感染的母亲妊娠期合并低蛋白血症对母亲及新生儿的影响。方法对2012年4月1日至7月31日于我院分娩的192例乙肝病毒感染的母亲及其新生儿的临床资料进行分析总结。按母亲分娩前1周内血清总蛋白及白蛋白含量分为2组:低蛋白血症组(A组)92例,和血浆蛋白正常组(B组)100例,对两组母亲的孕产期情况,包括是否发生妊娠期糖尿病(包括糖耐量异常)、胎儿宫内窘迫、早产、羊水异常及新生儿出生后Apgar评分、体重以及出生后1小时静脉血浆蛋白含量进行比较。结果 A组母亲并发妊娠期糖尿病6例(6.5%)、胎儿宫内窘迫12例(13.0%),B组分别为1例(1.0%)和5例(5.0%),A组的发生率均高于B组(P<0.05),早产、羊水异常发生率两组差异无统计学意义(P>0.1);A组新生儿1分钟阿氏评分7.4±1.1分,血浆总蛋白65.63±7.77g/L,白蛋白41.83±3.15g/L,B组新生儿分别为8.3±1.2分,67.76±6.47g/L,43.39±3.28 g/L,A组均不同程度低于B组,差异有统计学意义(分别P<0.05,P<0.001)。新生儿出生体重及5分钟、10分钟阿氏评分无显著性差异。结论乙肝病毒感染的母亲,并发低蛋白血症者较血浆蛋白正常者可能更易合并妊娠期糖尿病、胎儿宫内窘迫,同时与其新生儿的1分钟阿氏评分,血浆蛋白和/或白蛋白更低存在相关性,故积极纠正妊娠期低蛋白血症对HBV感染母亲及其新生儿都有重要意义。

Objectives To explore the effect of hypoalbuminemia in pregnant women with HBV infection on themselves and their babies. Methods According to the results of total serum protein and album level tested within lweek before the delivery day, a total of 192 mothers with HBV infection and their 192 newborns born in our hospital from April 1 to July 31 in 2012 were divided into Group A（mothers with hypoalbuminea）and Group B（mothers with normal album levels）. The morbidity of gestational diabetes mellitus （GDM, including abnormal glucose tolerance）, fetal distress in uterns（FIUD）, abnormal amniotic fluid, premature birth of mothers, and Apgar scores, birth weight, total serum protein and album level tested 1hour after birth of newborns, were compared between the two groups. Results The morbidity of GDM and FIUD of group A was 6.5% （6/92） and 13.0% （12/92） respectively, while in group B the morbidity was 1.0% （1/100） and 5.0（5/100）, and the difference between the two groups was statistically significant（P〈0.05）. The morbidity of abnormal amniotic fluid and premature birth was nt statistically different（P〉0.1）.The newborns＇ Apgar score at 1 minute was 7.4±1.1 in group A and 8.3±1.2 in group B, babies＇total serum protein and album level were 65.63±7.77g/L and 41.83±3.15g/L respectively in Group A, while those were 67.76±6.47g/L and 43.39±3.28 g/L in group B, and all these results was statistically different （P〈0.05 or P〈0.001）, while the newborns＇ weight and Apgar score at 5 and 10 minutes was not statistically difference between the two groups. Conelusions Compared with pregnant women with HBV infection with normal album level, mothers with hypoalbuminemia have chance to get GDM and FIUD, and their newborns＇ Apgar score at 1 minute, the total serum protein and album level are lower than mothers with normal albuminemia. Proper treatment of hypoalbuminemia in pregnant women is important to both mothers with HBV infection and their babies.