辅助生殖技术受孕的极低及超低出生体质量儿死亡相关因素分析

Analysis of factors related to death of infants with extremely and very low birth weight after assisted reproductive technology

目的探究影响辅助生殖技术(ART)受孕的极低及超低出生体质量儿死亡的临床因素,为临床干预提供科学依据。方法回顾性分析2014年7月至2016年7月郑州大学第一附属医院收治的81例辅助生殖技术(ART)受孕的极低及超低出生体质量儿的临床资料,运用Logistic回归分析,筛选其死亡相关因素。结果单因素Logistic回归分析:胎龄、剖宫产、窒息、新生儿酸中毒、新生儿低血糖症、呼吸衰竭、心力衰竭是影响经ART出生新生儿预后的因素(P<0.05);多因素Logistic回归分析:窒息、低血糖是死亡的独立危险因素,胎龄大为保护因素。结论辅助生殖技术受孕的极低及超低出生体质量儿的死亡率较高,可通过正确规范的复苏降低窒息的死亡率,及时调整血糖,对ART受孕后的母亲进行密切而细致的围产期检查,并尽量避免所有导致早产的因素,使胎龄接近足月,提高存活率。

Objective To explore the clinical factors that affect the survival of extremely and very low birth weight infants with use of Assisted reproductive technology（ ART）, and to provide a scientific basis for clinical treatment. Methods This retrospective study included 81 extremely and very low birth weight live - born infants after ART born between July of 2014 and July of 2016 at neonatal intensive care units of the First Affiliated Hospital of Zhengzhou University within 72 hours. Clinical data including high risk factors of mother, general conditions, birth conditions, neonatal morbidities, and major treatment measures and outcome, during the initial hospitalization as well as post - neonatal hospitalizations were multivariate Logistic regression analysed to screen clinical factors related to death. Results Univariate analysis showed that gestational age, cesarean section, asphyxia, neonatal acidosis, neonatal hypoglycemia, respiratory failure, heart failure and anemia were the potential prognostic factors of prognostic. Multivariate regression analysis showed that asphyxia and neonatal hypoglycemia were risk factors, and gestational age were protective factors. Conclusion Asphyxia, hypoglycemia were risk factors, while hospital days, and gestational were protective factors.