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湖北恩施土家族苗族自治州新生儿窒息流行病学调查及围产期高危因素分析 被引量:23

Epidemiology and perinatal risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture
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摘要 目的了解湖北恩施土家族苗族自治州新生儿窒息的发生率及高危因素。方法采用填写调查表的方法,对2016年1至12月在16家不同等级医疗机构分娩或救治的活产婴儿(包括出院诊断为新生儿窒息患儿)的基本情况、围产期相关因素等相关资料进行回顾性调查。其中三级甲等医院4家(综合医院3家、中医医院1家),二级甲等医院12家(综合医院8家、妇幼保健院1家、中医医院3家)。采用χ2检验进行统计学分析。结果共纳入活产婴儿22 294例,出院诊断为新生儿窒息的有733例(3.29%),其中轻度窒息627例(85.54%),重度窒息106例(14.46%)。因新生儿窒息而死亡的病例27例,病死率为3.68%(27/733)。新生儿窒息发生的高危因素包括:新生儿为多胎、辅助生殖技术妊娠、早产儿、低出生体重儿、胎位异常、合并先天性畸形、男婴、途中分娩,母亲为土家族、小学及以下文化程度、居住在农村、孕期产前检查次数≤3次,母亲孕期发生早期先兆流产、孕期贫血、妊娠期高血压疾病、绒毛膜羊膜炎、异常妊娠史以及脐带、羊水或胎盘异常。结论恩施地区新生儿窒息发生率明显高于全国平均水平,影响新生儿窒息发生的高危因素主要与母亲的基本情况、孕期及分娩情况及新生儿出生时情况有关。 Objective To investigate the incidence and risk factors of neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture. Methods Live born infants, including those diagnosed with neonatal asphyxia, were recruited from 16 different hospitals in Hubei Enshi Tujia and Miao Autonomous Prefecture from January to December of 2016. The 16 hospitals included four grade A tertiary hospitals (three general hospitals and one traditional Chinese medicine hospital) and 12 grade A secondary hospitals (eight general hospitals, one maternal and child health hospital and three traditional Chinese medicine hospitals). A retrospective investigation was conducted using questionnaire to analyze the basic information, perinatal risk factors and prognosis of those infants. Chi-square test was used for statistical analysis. Results Among 22 294 recruited live born infants, 733 (3.29%) were diagnosed with neonatal asphyxia on discharge, including 627 (85.54%) mild cases and 106 (14.46%) severe cases. And neonatal asphyxia resulted in deaths of 27 cases (3.68%). The risk factors for neonatal asphyxia included multiple pregnancy, pregnancy conceived with assisted reproductive technology, premature infant, low birth weight infant, fetal malposition, congenital malformation, male infant, born during transfer, mother of Tujia nationality, low educational level (primary school or lower), living in rural area, the number of antenatal visits ≤3, history of early threatened abortion, anemia in pregnancy, hypertensive disorders of pregnancy, chorioamnionitis, abnormal pregnancy history and abnormality of umbilical cord, amniotic fluid or placenta. Conclusions The incidence of neonatal asphyxia in Enshi area is obviously higher than the national average. The main risk factors for neonatal asphyxia in this area are related to maternal background and the living condition of the mother during pregnancy, delivery as well as the newborn at birth.
作者 吴素英 彭芬 丁婷 谭红燕 吴倩 刘红艳 于新桥 谭从容 盘志平 袁作芬 黄振菊 夏世文 Wu Suying;Peng Fen;Ding Ting;Tan Hongyan;Wu Qian;Liu Hongyan;Yu Xinqiao;Tan Congrong;Pan Zhiping;Yuan Zuofen;Huang Zhenju;Xia Shiwen(Department of Neonatology, University Hospital of Hubei University for Nationalities, Enshi 445000, China;Department of Neonatology, Hubei Maternal and Child Health Hospital, Wuhan 430070, China;Department of Pediatrics, the Central Hospital of Enshi Autonomous Prefecture, Enshi 445000, China;Department of Pediatrics, Enshi Autonomous Prefecture Hospital for Nationality, Enshi 445000, China;Department of Neonatology, Lichuan People's Hospital, Lichuan 445400, China;Department of Pediatrics, Enshi Central Hospital, Enshi 445000, China)
出处 《中华围产医学杂志》 CAS CSCD 北大核心 2019年第8期575-580,共6页 Chinese Journal of Perinatal Medicine
基金 湖北省卫生健康委员会科研项目(WJ2019F148).
关键词 新生儿窒息 发病率 危险因素 少数民族 Asphyxia neonatorum Incidence Risk factors Minority Groups
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