早产儿视网膜病变的危险因素分析

Analysis on the maternal risk factors for retinopathy of prematurity in premature infants

目的分析患儿母亲孕产期因素与早产儿视网膜病变(ROP)发病情况的相关性,以期为ROP的防治提供科学依据。方法选取2016年6月-2017年6月在湖南省妇幼保健院眼科门诊完成RetCam3眼底检查的早产儿,记录早产儿眼底检查结果,同时收集早产儿胎龄、出生体重及其母亲孕期资料(孕期年龄、胎次、妊娠期相关疾病),进行回顾性分析。结果1956例早产儿中筛查出早产儿视网膜病变354例,检出率为18.10%。Logistic回归分析早产儿视网膜病变的高危因素有胎龄<28周(OR=21.649,95%CI:18.485~24.327)、低出生体重(<1000g)(OR=13.013,95%CI:10.861~16.233)、母亲孕期胎儿窘迫(OR=2.328,95%CI:1.269~3.156)、患有妊娠期高血压(OR=2.121,95%CI:1.072~3.571)、妊娠期糖尿病(OR=1.995,95%CI:1.008~2.929)。而孕期年龄、胎次及孕妇有无贫血与ROP的发生与否差异均无统计学意义(P>0.05)。结论早产儿的出生胎龄<28周、低出生体重(<1000g)、母亲孕期胎儿窘迫、患有妊娠期高血压、妊娠期糖尿病等与早产儿视网膜病变的发生密切相关。

Objective To analyze the correlation between pregnancy and prenatal risk factors and occurrence of retinopathy of prematurity(ROP),in order to provide scientific evidence for the prevention and treatment of ROP. Methods Premature infants with profiles,who were completed the RetCam 3 fundus examination in eye clinic of Hunan Provincial Maternal and Child Health Care Hospital from June 2016 to June 2017,were included.RetCam 3 fundus examination Results,gestational age,birth weight,maternal age,parity,pregnancy related diseases were recorded and analyzed statistically to explore the risk factors for ROP. Results A total of 1 956 cases of premature were included and 354 ROP patients were identified(18.10%).Logistic regress analysis indicated that gestational age <28 weeks(OR=21.649,95%CI:18.485-24.327),low birth body weight(<1 000 g)(OR=13.013,95%CI:10.861-16.233),fetal distress(OR=2.328,95%CI:1.269-3.156),gestational hypertension(OR=2.121,95%CI:1.072-3.571),gestational diabetes mellitus(OR=1.995,95%CI:1.008-2.929) were high-risk factors for the development of ROP in premature infants,while pregnant women age,parity and anemia during pregnancy were not significantly correlated with ROP(P>0.05). Conclusion Factors including preterm infants with gestational age<28 weeks and low birth body weight(<1 000 g),fetal distress,mother with gestational hypertension and gestational diabetes mellitus,are closely related to ROP.