产妇既往分娩状况对新生儿下呼吸道感染的影响

Effect of maternal past delivery status on neonatal lower respiratory tract infection

目的探讨产妇既往分娩状况对新生儿下呼吸道感染的影响,旨在降低新生儿下呼吸道感染发生率。方法选取2018年1月-2018年12月武汉市妇女儿童医疗保健中心收治的296例产妇为研究对象,根据新生儿是否发生下呼吸道感染分为两组,研究组新生儿发生下呼吸道感染,共109例,对照组新生儿未发生下呼吸道感染,共187例,比较两组产妇的年龄、体质量指数、孕周、既往分娩状况,归纳新生儿下呼吸道感染的影响因素,并对发生感染的新生儿进行病原菌检测与鉴定,分析病原菌的种类。结果研究组产妇顺产共31例(28.44%),剖宫产共78例(71.56%),首次分娩共24例(22.02%),二次分娩共38例(34.86%),二次以上分娩共47例(43.12%)与对照组比较,差异均有统计学意义(P<0.05);剖宫产、分娩次数是导致新生儿下呼吸道感染的影响因素(P<0.05);109例感染新生儿共检测出病原菌117株,其中革兰阴性菌75株占64.10%,以铜绿假单胞菌和肺炎克雷伯菌为主;革兰阳性菌36株占30.77%,以金黄色葡萄球菌为主;真菌6株占5.13%。结论产妇既往分娩状况与新生儿下呼吸道感染的发生密切相关,剖宫产、分娩次数增加会增加新生儿下呼吸道感染的风险,临床应加以重视。

OBJECTIVE To investigate the effect of maternal past delivery on neonatal lower respiratory tract infections,so as to reduce the incidence of lower respiratory tract infections in newborns.METHODS Totally 296 maternal patients admitted to Wuhan Women and Children’s Medical and Health Care Center from Jan.2018 to Dec.2018 were selected as the research subjects and divided into two groups based on whether the newborns occurred lower respiratory infections.Totally 109 neonatal lower respiratory tract infections occurred in the study group,and 187 neonatal lower respiratory tract infections did not occcurred in the control group.The maternal age,body mass index,gestational week,and previous delivery status were compared between the two groups of women,and the influencing factors of neonatal lower respiratory tract infection were summarized.The pathogenic bacteria were detected and identified,and the types of pathogenic bacteria were analyzed.RESULTS In the study group,there were 31 cases(28.44%)of natural labouring,78 cases(71.56%)of the cesarean section,24 cases(22.02%)of the first delivery,38 cases(34.86%)of the second delivery,and 47 cases(43.12%)of the second delivery,which were significantly different from the control group(P<0.05).The number of cesarean section and childbirths were the influencing factors of lower respiratory tract infection(P<0.05).A total of 117 pathogenic bacteria were detected in 109 infected newborns,of which 75 Gram-negative bacteria accounted for 64.10%,mainly by Pseudomonas aeruginosa and Klebsiella pneumoniae;36 Gram-positive bacteria accounted for 30.77%,mainly by Staphylococcus aureus,and 6 fungi accounted for 5.13%.CONCLUSION Maternal previous delivery status is closely related to the occurrence of neonatal lower respiratory tract infections.Increasing the number of cesarean sections and delivery increases the risk of neonatal lower respiratory tract infections,which should be taken seriously in clinical practice.