胎儿宫内窘迫相关因素及与新生儿出生结局的临床关系研究

Study on the Clinical Relationship of Related Factors of Intrauterine Distress with Neonatal Birth Outcome

目的:分析胎儿宫内窘迫相关因素及与新生儿出生结局的临床关系。方法:选取某院2017年10月~2018年12月收住的孕妇2700例进行研究分析,其中胎儿宫内窘迫有200例(7.41%)。对全部孕妇临床资料采取回顾性分析,通过Logistic回归多因素分析胎儿窘迫相关因素。结果:通过分析单因素结果显示,分娩方式、孕周、分娩史、胎盘异常、胎膜早破、24h尿蛋白量、羊水异常、纤维蛋白原、妊娠期高血压病、胎位异常、胎儿出生体重以及脐带异常等均为导致新生胎儿窘迫的危险因素(P<0.05);经过Logistic多因素回归分析显示,羊水异常、阴道助产、纤维蛋白原、胎膜早破、24h尿蛋白、胎位异常、胎儿体重以及脐带异常等是胎儿窘迫的危险因素(P<0.05);而OR值较高的因素有阴道助产、胎位异常以及羊水异常等。结论:对于产前舒张压较高、存在分娩史、纤维蛋白原偏低以及24h尿蛋白偏高的孕产妇应加强监护,及时诊断,从而进行针对性干预治疗。

Objective:To analyze the clinical relationship of related factors of intrauterine distress with neonatal birth outcome.Methods:A total of 2,700 pregnant women admitted to a hospital from October 2008 to December 1818 were enrolled in the study.There were 200 cases(7.41%)of intrauterine distress in the hospital.The clinical data of all pregnant women were analyzed retrospectively and the factors related to fetal distress were analyzed by Logistic regression.Results:Single factor analysis showed that delivery mode,gestational week,delivery history,abnormal placenta,premature rupture of membranes,24h urine protein volume,abnormal amniotic fluid,fibrinogen,gestational hypertension,abnormal fetal position,fetal birth weight and abnormal umbilical cord were all risk factors leading to fetal distress(P<0.05);Logistic multivariate regression analysis showed amniotic fluid abnormalities,vaginal midwifery,fibrinogen,premature rupture of membranes,24h urine protein,abnormal fetal position,fetus Body weight and umbilical cord abnormalities are risk factors for fetal distress(P<0.05),and higher OR values include vaginal midwifery,abnormal fetal position,and amniotic fluid abnormalities.Conclusion:For prenatal diastolic blood pressure,pregnant women with a history of childbirth,low fibrinogen and high 24-h urinary protein should be intensively monitored and diagnosed in time so as to conduct targeted intervention.