母婴同室新生儿皮肤感染危险因素的调查分析

Risk factors for skin infection of newborn infants in maternal-neonatal unit

目的通过回顾性病例对照研究，分析发生母婴同室新生儿皮肤感染的危险因素，为预防新生儿皮肤感染提供依据。方法收集2016年1月至2017年12月母婴同室新生儿共10823例的临床资料，通过比较皮肤感染者与健康者，筛选发生皮肤感染的危险因素。结果共发生新生儿皮肤感染271例，感染率为2．5％，其中感染类型以脓疱疮为主，占94．8％。单因素分析发现剖宫产（P=0．001）、产程延长（P=0．015）、胎膜早破（P=0．030）、羊水异常（P=0．043）、出生时窒息（P=0．036）是发生新生儿皮肤感染的危险因素，进一步多因素Logistic回归分析结果显示新生儿皮肤感染的独立危险因素为：产程延长（OR=2．96）、胎膜早破（OR=1．71）、羊水异常（OR=2．16）、出生时窒息（OR=1．45）。结论母婴同室新生儿皮肤感染的独立危险因素是产程延长、胎膜早破、羊水异常及出生时窒息，应采取积极的预防和控制措施以减少新生儿皮肤感染的发生。

Objective To identify the risk factors of skin infection of newborn infants in maternalneonatal unit by the case-control methodology. Methods The clinical data of 10 823 newborn infants in maternalneonatal unit was collected from January 2016 to December 2017. The data of newborn infants diagnosed with skin infection was compared with those without infection. The effect of each variable on skin infection was assessed by the Logistic regression analysis. Results A total of 271 cases of neonatal skin infection occurred and the infection rate was 2.5%. Most of the infection type was impetigo, accounting for 94.8%. According to univariate analysis, the factors associated with neonatal skin infection were cesarean section （P=-0.001）, prolonged labor （P=0.015）, premature rupture of membranes （P=0.030）, amniotic fluid abnormalities （P=0.043）, and asphyxia at birth （P=0.036）. The multivariate Logistic regression analysis showed that the independent risk factors of skin infection in newborns were prolonged labor （OR=2.96）, premature rupture of membranes （OR=1.71）, amniotic fluid abnormality （OR=2.16）, and asphyxia at birth （OR=1.45）. Conclusions The independent risk factors for skin infections of newborn infants in maternal-neonatal unit are prolonged labor, premature rupture of membranes, amniotic fluid abnormalities, and asphyxia at birth, hence active prevention or control measures should be taken for these risk factors to reduce the incidence Of neonatal skin infection.