2003年~2015年广西地区胎儿水肿综合征患儿死亡影响因素分析

Risk factors of infant death with hydrops fetalis syndrome in Guangxi area from 2003 to 2015

目的分析广西地区胎儿水肿综合征(Hydrops fetalis syndrome,HFS)患儿死亡的独立危险因素,为减少HFS患儿死亡提供防治策略,从而改善HFS患儿结局。方法回顾性分析比较2003年至2015年广西地区HFS患儿存活和死亡的基本情况,用logistic回归分析HFS死亡的独立危险因素。结果 2003年至2015年广西地区诊断HFS共5196例,引产3924例(75.52%),未引产的798人中,存活227例(28.45%),死亡571例(71.55%)。多因素Logistic回归分析结果显示住地农村(OR=1.792,95%CI:1.185-2.708,P=0.006)、孕妇文化水平(OR=0.734,95%CI:0.568-0.949,P=0.018)以及胎龄(OR=0.841,95%CI:0.805-0.879,P<0.001)为HFS患儿死亡的危险因素。Logistic回归预测概率ROC曲线下面积为0.714(95%CI:0.673-0.755,P<0.001)。结论广西地区HFS自然死亡率明显高于存活率,孕妇文化水平越低及胎龄越小HFS患儿死亡的概率越大;农村家庭比城市家庭HFS患儿死亡的风险大。

Objective:We analyzed the risk factors of infant death with hydrops fetalis syndrome(HFS)in Guangxi area,to help reduce mortality of HFS infants so that improve the outcome of HFS infants.Methods:It is a retrospective study,we compared the suspect risk factors between survival group and death group and analyzed the risk factors of death outcome among HFS infants using logistic regression.Results:There were 5196 fetus diagnosed HFS.After excluding 3924?induced labor samples we divided the not induced labor samples into survival group(227,28.45%)and death group(571,71.55%).The results of logistic regression showed country area(OR=1.792,95% CI:1.185-2.708,P=0.006),culture?level?of?pregnant woman(OR=0.734,95%CI:0.568-0.949,P=0.018)and gestational?age(OR=0.841,95% CI:0.805-0.879,P<0.001)were risk factors of HFS infant death.Conclusion:The mortality rate of HFS infants was higher than survival rat.The lower culture?level?of?pregnant woman and the smaller?the?gestational?age,the higher mortality of HFS infants was.And the risk of death for HFS infants in countries was higher than in cities.