孕妇未足月胎膜早破发生的影响因素及对围产儿预后的影响

Influencing Factors of Preterm Premature Rupture of Membranes in Pregnant Women and Its Influence on Perinatal Prognosis

目的分析孕产妇未足月胎膜早破(PPROM)发生的影响因素及其对围产儿临床预后的影响。方法采用回顾性研究,收集本院92例足月胎膜早破产妇为A组,98例PPROM产妇为B组,均为单胎产妇,采用多因素Logistic回归分析PPROM的影响因素。结果单因素分析结果显示,两组孕产妇瘢痕子宫、子宫发育异常、妊娠期糖尿病(GDM)及妊娠期高血压疾病(HDIP)发生率差异均无统计学意义(P均>0.05);B组胎位异常(15.31%)及生殖道感染发生率(38.78%)均高于A组(3.26%、14.13%)(P均<0.01)。多因素Logistic回归分析结果显示,胎位异常(OR=3.86,95%CI:1.63~9.14)及生殖道感染(OR=10.70,95%CI:4.26~26.86)是PPROM发生的独立危险因素。新生儿临床结局显示,B组新生儿出生体质量和Apgar评分均低于A组(P均<0.01),新生儿肺炎及新生儿窒息发生率均高于A组(P均<0.01)。结论胎位异常及生殖道感染是孕妇发生PPROM的影响因素,且此类产妇新生儿出生体质量较轻,易导致新生儿肺炎及新生儿窒息等不良临床结局的发生。

Objective To analyze the influencing factors of premature rupture of membranes(PPROM)in pregnant women and its influence on the clinical prognosis of perinatal infants.Methods A retrospective study was conducted to collect 92 full-term women with premature rupture of membranes as group A and 98 PPROM women as group B.All of them were single pregnant women.The data were included in the statistical analysis.The influencing factors of PPROM were analyzed by multi-factor logistic regression.Results Univariate analysis showed that there was no statistic difference in the incidence of scarred uterus,uterine dysplasia,gestational diabetes mellitus(GDM)and hypertensive disorder in pregnancy(HDIP)between the two groups(P all>0.05),but the incidence of abnormal fetal position(15.31%)and genital tract infection(38.78%)in group B was significantly increased in comparison of group A(3.26%and 14.13%)(P all<0.01).Multivariate logistic regression analysis showed that abnormal fetal position(OR=3.86,95%CI:1.63-9.14)and reproductive tract infection(OR=10.70,95%CI:4.26-26.86)were the independent risk factors of PPROM.From the clinical outcome of neonates,the birth weight of group B was significantly lower than that of group A,the Apgar score of neonates was significantly lower than that of group A(P all<0.01),and the incidence of neonatal pneumonia and neonatal asphyxia was significantly higher than those in group A(P all<0.01).Conclusion Abnormal fetal position and reproductive tract infection are the influencing factors of PPROM in pregnant women,and the birth weight of such pregnant women is lighter,and neonatal pneumonia and neonatal asphyxia are prone to adverse clinical outcomes.