杭州市新生儿窒息发生情况及危险因素、预防措施调查分析

A survey of situation,risk factor,and preventive measures of neonatal asphyxia in Hangzhou city

目的:调查新生儿窒息发生情况,分析危险因素,探讨预防措施。方法:采用整群抽样法选取2019年5-8月杭州市10家医疗机构,收集该时间内住院分娩的活产儿及产妇为研究对象,采用统一编制的调查问卷对产妇孕期情况、人口学资料进行调查,logistic回归模型进行多因素分析。结果:954例新生儿中有51例(5.4%)发生窒息,其中轻度窒息43例(84.3%),重度窒息8例(15.7%);与窒息相关死亡4例,病死率7.8%;经logistic回归模型进行高危因素筛选显示,孕期感染、胎龄<37周、前置胎盘、羊水污染、宫内窘迫、宫缩乏力是影响新生儿窒息的独立危险因素,家庭年收入≥3万元为独立保护因素。结论:杭州市新生儿窒息发生率较高,影响新生儿窒息的危险因素较多,应加强围产期保健,积极预防并发症,密切观察产程进展,提高急救技能,以降低新生儿窒息发生率。

Objective:To investigate the incidence and the risk factors of neonatal asphyxia,and to explore the preventive measures.Methods:The cluster sampling was used to select 10 medical institutions from May to August 2019,the live birth and maternity in these medical institutions during this period were selected as objects.A unified questionnaire was used to investigate the pregnant situation and demographic data of women,and Logistic regression model was used for multivariate analysis.Results:A total of 51 of 954 newborns had asphyxia.The incidence of newborn asphyxia was 5.4%,which included 43 cases(84.3%)with mild asphyxia,8 cases(15.7%)with severe asphyxia,and 4 cases(7.8%)with deaths related to asphyxia.Logistic regression model analysis showed that infection during pregnancy,<37 gestational weeks,placenta previa,amniotic fluid pollution,intrauterine distress,and uterine atony were independent risk factors for neonatal asphyxia,and annual household income≥30000 were independent protective factor.Conclusion:The incidence of neonatal asphyxia is high in Hangzhou city,and there are many risk factors affecting neonatal asphyxia,so perinatal health care should be strengthen,complications during pregnancy should be actively prevented,the progress of labor should be closely observed,and emergency skills should be improved,so as to reduce the incidence of neonatal asphyxia.