未足月胎膜早破的危险因素及妊娠结局分析

Risk factors and neonatal outcomes of premature rupture of membranes

目的探讨未足月胎膜早破(PPROM)发生的危险因素及对新生儿结局的影响。方法选择产科门诊收治的146例PPROM患者设为PPROM组,另选择同期185例足月胎膜早破(TPROM)患者设为TPROM组。采用回归分析法对2组患者胎膜早破的相关因素进行统计学分析,并记录2组产妇的妊娠结局。结果 Logistic回归分析显示,孕妇血清血清维生素C(VC)、维生素E(VE)、铜(Cu2+)、锌(Zn2+)含量下降,双胎/多胎,存在胎位异常、生殖道感染、流产或引产史或胎膜早破史、产检次数过少、妊娠合并贫血、腹压增加,均是PPROM发生的危险因素(P<0.05);PPROM组胎儿生长受限、新生儿低体质量、呼吸窘迫综合征、肺炎、窒息的发生率及围产儿病死率均显著高于TPROM组(P<0.05)。结论孕妇发生PPROM的因素复杂多样,因此应做好育龄女性的健康及生殖卫生宣教工作,以有效预防PPROM发生,改善新生儿健康状况。

Objective To explore the risk factors of premature rupture of membranes(PPROM)and its impact on neonatal outcomes.Methods A total of 146 patients with PPROM admitted to obstetric department were selected as the PPROM group.Another 185 cases with full-term premature rupture of membranes(TPPROM)were selected as the TPPROM group.The related factors of premature rupture of membranes in two groups were analyzed by regression analysis,and maternal pregnancy outcomes were recorded in both groups.Results Logistic regression analysis showed that serum vitamin C(VC),serum vitamin E(VE),serum Cu 2+,serum Zn 2+levels in pregnant women were decreased,twins/multiples,abnormal fetal position,reproductive tract infection,abortion or induction of labor or premature rupture of membranes,few prenatal examinations,pregnancy combined with anemia and increased abdominal pressure were risk factors for PPROM(P<0.05).Fetal growth restriction,neonatal and low body weight,respiratory distress syndrome,pneumonia,asphyxia and perinatal mortality were significantly higher in the PPROM group than that in the TPROM group(P<0.05).Conclusion Occurrence of PPROM in pregnant women is caused by complicated and diverse factors.Therefore,the health and reproductive health education for women of childbearing age is of great significance to effectively prevent the occurrence of PPROM and improve the health of newborns.