早期新生儿贫血的围生期危险因素临床分析

Clinical analysis of perinatal risk factors of early neonatal anemia

目的探讨早期新生儿贫血的围生期危险因素,以减少和预防早期新生儿贫血的发生。方法选取145例早期贫血新生儿作为贫血组,选取同时期200例无贫血新生儿作为对照组。分析两组新生儿贫血的围生期因素(胎盘异常、双胎输血综合征、医源性失血、早产儿、产时出血、重度窒息、脐带异常、新生儿ABO溶血病、G-6-PD缺陷)。结果贫血组中胎盘异常19例、双胎输血综合征7例、医源性失血9例、早产儿51例、产时出血4例、重度窒息1例、脐带异常7例、新生儿ABO溶血病25例、G-6-PD缺陷41例。对照组中胎盘异常3例、双胎输血综合征0例、医源性失血0例、早产儿44例、产时出血2例、重度窒息1例、脐带异常8例、新生儿ABO溶血病8例、G-6-PD缺陷15例。贫血组胎盘异常、双胎输血综合征、医源性失血、新生儿ABO溶血病、G-6-PD缺陷比例均高于对照组,差异有统计学意义(P<0.05);贫血组早产儿、产时出血、重度窒息及脐带异常比例与对照组比较,差异无统计学意义(P>0.05)。结论早期新生儿贫血的围生期因素主要与新生儿ABO溶血病、G-6-PD缺陷、胎盘异常、双胎输血综合征和医源性失血有关,在围生期注意上述因素,有利于减少早期新生儿贫血。

Objective To explore the perinatal risk factors of early neonatal anemia to reduce and prevent the occurrence of the early neonatal anemia. Methods There were 145 early anemia newborns as anemia group, and concurrent 200 non anemia newborns as control group. Analysis was made on perinatal factors（abnormal placenta, twin-to-twin transfusion syndrome, iatrogenic blood loss, premature infant, intrapartum hemorrhage, severe asphyxia, abnormal umbilical cord, neonatal ABO hemolytic disease, G-6-PD defect） in two groups. Results The anemia group had 19 abnormal placenta cases, 7 twin-to-twin transfusion syndrome cases, 9 iatrogenic blood loss cases, 51 premature infant cases, 4 intrapartum hemorrhage cases, 1 severe asphyxia case, 7 abnormal umbilical cord cases, 25 neonatal ABO hemolytic disease cases, 41 G-6-PD defect cases, while the control group had 3 abnormal placenta cases, 0 twin-to-twin transfusion syndrome case, 0 iatrogenic blood loss case, 44 premature infant cases, 2 intrapartum hemorrhage cases, 1 severe asphyxia cases, 8 abnormal umbilical cord cases, 8 neonatal ABO hemolytic disease cases, 15 G-6-PD defect cases. The anemia group had higher proportion of abnormal placenta, twin-to-twin transfusion syndrome, iatrogenic blood loss, neonatal ABO hemolytic disease, and G-6-PD defect than the control group, and the difference had statistical significance（P〈0.05）. The anemia group had no statistically significant difference in proportion of premature infant, intrapartum hemorrhage, severe asphyxia, abnormal umbilical cord than the control group（P〉0.05）. Conclusion Perinatal period factors of early neonatal anemia are mainly related to neonatal ABO hemolytic disease, G-6-PD defect, abnormal placenta, twin-to-twin transfusion syndrome and iatrogenic blood loss. Attention should be payed to the above factors, and it is helpful to reduce early neonatal anemia.