早产小于胎龄儿的临床特点及高危因素分析

Clinical Characteristics and High Risk Factors of Premature Infants with Small for Gestational Age

目的了解早产小于胎龄儿(SGA)的临床特点及高危因素,为临床医生对加强早产儿SGA的健康管理及预防早产儿SGA的发生提供科学依据。方法收集2017年11月~2019年11月安徽医科大学附属妇幼保健院新生儿科收治的1074例早产儿,根据胎龄与出生体重分为小于胎龄儿(SGA)组与适于胎龄儿(AGA)组,比较两组早产儿出生后的免疫及血生化指标、住院期间的并发症、母亲妊娠期的相关情况,并采用Logistic回归分析发生SGA的影响因素。结果SGA组Glu、TG、TC、HDL、Ca、P、25羟维生素D低于AGA组,cTnI、LDL、TSH高于AGA组,差异有统计学意义(P<0.05);SGA组新生儿喂养不耐受、低血糖症、低甲状腺素血症、中性粒细胞减少症发生率高于AGA组,差异有统计学意义(P<0.05);SGA组母妊娠期高血压疾病、多胎妊娠、胆汁淤积症的发生率高于AGA组,差异有统计学意义(P<0.05);Logistic回归分析显示,母患有妊娠期高血压疾病、多胎妊娠、胆汁淤积症是SGA发生的影响因素。结论母患有妊娠期高血压疾病、多胎妊娠、胆汁淤积症与SGA的发生密切相关,应加强早产儿SGA住院期间的临床管理、出院后随访,可改善早产儿SGA的近、远期并发症结局,提高SGA早产儿的生活质量;加强孕期保健,可降低早产儿SGA的发生率。

Objective The clinical characteristics and risk factors of premature infants small for gestational age(SGA)were analyzed to provide scientific basis for clinicians to strengthen health management of SGA and prevent SGA occurrence of premature infants.Methods A total of 1074 premature infants admitted to the neonatal department of Maternal and Child Health Hospital affiliated to Anhui Medical University from November 2017 to November 2019 were divided into the SGA group and the AGA group according to their gestational age and birth weight.The immune and blood biochemical indexes,complications during hospitalization,and maternal gestation status of the two groups of premature infants were compared.Results SGA group Glu,TG,TC,HDL,Ca,P,25-hydroxyvitamin D were lower than AGA group,cTnI,LDL,TSH were higher than AGA group,the difference was statistically significant(P<0.05);SGA group neonatal feeding is not the incidence of tolerance,hypoglycemia,hypothyroxinemia,and neutropenia was higher than that of the AGA group,the difference was statistically significant(P<0.05);the SGA group had maternal hypertension,multiple pregnancy,and bile incidence of stasis was higher than that of the AGA group,the difference was statistically significant(P<0.05);Logistic regression analysis showed that mothers suffering from hypertension during pregnancy,multiple pregnancy,and cholestasis were the influencing factors of SGA.Conclusion Maternal hypertension during pregnancy,multiple pregnancy and cholestasis are closely related to the occurrence of SGA.Therefore,clinical management during hospitalization of SGA and follow-up after discharge should be strengthened to improve the outcome of near and long-term complications of SGA in premature infants and improve the quality of life of SGA premature infants.Strengthening prenatal care can reduce the incidence of SGA in premature infants.