重度子痫前期对早产儿呼吸系统并发症影响

INFLUENCE OF SEVERE PREECLAMPSIA ON RESPIRATORY SYSTEM COMPLICATIONS IN PRETERM INFANTS

目的通过分析重度子痫前期孕妇分娩早产儿的新生儿期临床特点及预后,探讨重度子痫前期对早产儿呼吸系统并发症的影响。方法2016年11月—2018年11月,选取入住我院新生儿重症监护室(NICU)重度子痫前期孕妇分娩早产儿163例为子痫组,同期住院血压正常孕妇分娩胎龄匹配早产儿291例为对照组,对两组孕妇及其新生儿临床资料进行分析,观察两组早产儿呼吸系统疾病发生和呼吸支持情况。结果两组孕妇年龄、孕产次、早产儿胎龄、妊娠期糖尿病、胎膜早破、绒毛膜羊膜炎等相比较,差异均无显著意义(P>0.05)。与对照组比较,子痫组早产儿出生体质量和Apgar评分(1 min)降低(t=-8.844、-2.322,P<0.01);新生儿呼吸窘迫综合征(NRDS)、支气管肺发育不良(BPD)及重度BPD发生率升高(χ^2=-5.432、5.455,u c=-2.402,P<0.05);无创通气时间及用氧时间明显延长(Z=-3.518、-2.772,P<0.01),但有创通气时间、肺表面活性物质使用及次数比较差异无统计学意义(P>0.05)。结论重度子痫前期可导致胎儿宫内生长受限,增加NRDS、BPD的发生,延长早产儿需氧及呼吸支持时间。

Objective To investigate the clinical outcome and prognosis of preterm infants born to mothers with severe preeclampsia in the neonatal period and the influence of severe preeclampsia on respiratory system complications in preterm infants.Methods A total of 163 preterm infants born to mothers with severe preeclampsia who were admitted to the neonatal intensive care unit(NICU)in our hospital from November 2016 to November 2018 were enrolled as eclampsia group,and 291 preterm infants,matched for gestational age,whose mothers had normal blood pressure,were enrolled as control group.The clinical data of the pregnant women and their neonates were analyzed,and the incidence rate of respiratory diseases and respiratory support were observed for the two groups.Results There were no significant differences between the two groups in maternal age,times of pregnancy and delivery,gestational age of preterm infants,gestational diabetes,premature rupture of membranes,and chorioamnionitis(P>0.05).Compared with the control group,the eclampsia group had significantly lower birth weight and 1-minute Apgar score(t=-8.844,-2.322;P<0.01),significantly higher incidence rates of neonatal respiratory distress syndrome(NRDS),bronchopulmonary dysplasia(BPD),and severe BPD(χ^2=-5.432,5.455;u c=-2.402;P<0.05),and significantly longer duration of noninvasive ventilation and oxygen supply time(Z=-3.518,-2.772;P<0.01).There were no significant differences in duration of invasive ventilation and number of times of pulmonary surfactant administration between the two groups(P>0.05).Conclusion Severe preeclampsia can cause intrauterine growth restriction of the fetus,increase the incidence rates of NRDS and BPD,and prolong the duration of oxygen supply and respiratory support in preterm infants.