二产新生儿近期临床结局——单中心队列研究

Short-term clinical outcomes of neonates of secundiparous mothers:a single-center cohort study

目的探讨第二产次的新生儿的近期临床结局,为生育政策改变后围产期的临床工作提供参考依据。方法对2015年6月至2016年4月在浙江省永康市妇幼保健院分娩的产妇及其新生儿进行队列研究,根据产次分为一产组和二产组,比较两组新生儿的近期临床结局。结果符合纳入标准的新生儿共4 091例,其中一产组2 023例,二产组2 068例。二产组孕母年龄多在26~34岁(57.16%),35岁以上者占16.49%。二产组新生儿剖宫产出生率高于一产组(42.55%vs 25.06%,P<0.05)。二产组住院新生儿中新生儿呼吸窘迫综合征(NRDS,8.6%vs 3.4%)及新生儿湿肺(7.2%vs 2.6%)在新生儿疾病构成比中的比例高于一产组(P<0.05)。结论高龄产妇不是当前生育二孩的主要人群。二产新生儿剖宫产出生率较一产新生儿高,这可能是导致二产住院新生儿中NRDS和新生儿湿肺等呼吸系统疾病占比较高的原因之一。

Objective To investigate the short-term clinical outcomes of neonates of secundiparous mothers,and to provide a reference for the clinical practice after the change in birth policy.Methods A cohort study was performed for the parturients and their neonates born in Yongkang Maternal and Child Health Care Hospital in Zhejiang,China between June 2015 and April 2016.According to the parity of the mother,the neonates were divided into primiparous group and secundiparous group.The short-term clinical outcomes of neonates were compared between the two groups.Results A total of 4 091 neonates who met the inclusion criteria were enrolled,and there were 2 023 neonates in the primiparous group and 2 068 in the secundiparous group.In the secundiparous group,most mothers（57.16%） were aged 26-34 years,and 16.49% were aged above 35 years.Compared with the primiparous group,the secundiparous group had a significantly higher rate of births by cesarean section（42.55% vs 25.06%;P0.05）.The percentages of neonatal respiratory distress syndrome（NRDS;8.6% vs 3.4%） and transient tachypnea of the newborn（TTN;7.2% vs 2.6%;P0.05） in hospitalized neonates from the secundiparous group were significantly higher than in those from the primiparous group.Conclusions Elderly parturient women are not the major population of secundiparous parturients.The neonates of secundiparous mothers have a higher rate of births by cesarean section,which might be associated with increased percentages of NRDS and TTN in hospitalized neonates from the secundiparous mothers.