脐动脉血气异常相关危险因素的病例对照研究

A case control study on risk factors of umbilical arterial blood gas

目的探讨脐动脉血气异常的相关危险因素。方法本研究采用病例对照研究设计,以270例脐动脉血pH值<7.2的新生儿为病例组,以270例脐动脉血pH值≥7.2的新生儿为对照组。采用单因素和多因素Logistic回归分析模型,分析两组中与脐动脉血气相关的危险因素的差别,以判断哪些危险因素与脐动脉血气异常相关。结果单因素分析显示产新生儿性别、生产次数、孕周、胎儿分娩方式、羊水性质、胎儿窘迫、宫缩乏力、瘢痕子宫等因素在两组中的分布存在显著性的差异(P<0.05)。把这些因素引入Logistic回归分析模型,多因素的分析结果显示,新生儿性别(OR95%CI:1.040~2.261)、产次(OR95%CI:1.348~2.614)、孕周(OR95%CI:0.298~0.956)、胎儿分娩方式(OR95%CI:1.729~3.057)和羊水性质(OR95%CI:0.575~0.849)、胎儿窘迫(OR95%CI:0.029~0.416)与脐动脉血气PH值的异常降低有关。另外对经阴道分娩的新生儿的研究发现,pH值异常组的第一产程的平均时间(406.26 min)和第二产程的平均时间(48.87 min)显著高于pH值正常组第一产程(310.18 min)和第二产程(35.24 min)(P<0.05)。结论新生儿性别(男性)、生产次数(初产妇)、孕周(>40)、胎儿娩出方式(经阴道分娩)、羊水性质(Ⅲ度)、胎儿窘迫以及产程时间长是引起新生儿脐动脉血气异常的重要危险因素。

Objective：To investigate the risk factors of umbilical arterial blood gas. Methods：In this study, a ease-con- trol study was designed. A total of 270 neonates with umbilical artery blood pH 〈 7.2 were included in the case group. 270 neonates with umbilical artery blood pH value of 7.2 were included in the control group. Univariate and multivariate Logis- tic regression models were used. The risk factors of umbilical artery blood gas in two groups were analyzed to determine the risk factors associated with umbilical arterial blood gas. Results ： Univariate analysis showed that the distribution of newborn sex, number, gestational age, fetal childbirth, the amniotic fluid, fetal distress, uterine atony, uterine scar and other fac- tors were significant in the two groups （P 〈 0.05 ）. These factors were introduced into Logistic regression model, and the results of multivariate analysis showed that neonatal sex （ OR95% CI： 1. 040 - 2.261 ）, yield （ OR95 % CI： 1. 348 - 2.614）, gestational age（ OR95% C1：0.298 - 0.956 ）, fetal delivery mode（ OR 95% CI ： 1. 729 - 3. 057 ）, amniotic fluid properties （ OR95% CI：0. 575 - 0. 849 ）, fetal distress （ OR95% CI： 0. 029 - 0. 416 ） were associated with an abnormal reduction in umbilical arterial blood gas. Abnormal group the first stage of labor time and the time of the second stage of labor time were 406.26 raln and 48.87 min, which were significantly higher than those of the normal group 310.18 rain and 35. 24 min（P 〈 0.05 ）. A study showed that the delivery of newborn babies, the operation time, dietary recovery time and hospitalization time of the observation group were significantly shorter than control group （P 〈 0.05）. Conclusion： Neonatal sex （male）, frequency of production（primipara） , gestational age （ 〉 40）,fetal childbirth （vaginal delivery）, amniotic fluid properties （Ⅲ）, fetal distress and long duration of labor are important risk factors for neonatal umbilical arterial blood gas.