抗菌药应用时机对足月胎膜早破母婴结局影响的回顾性分析

Retrospective Analysis of the Timing of Antibiotic Application on Maternal and Infant Outcomes of Term Premature Rupture of Membranes

目的:探讨产前不同时机预防性应用抗菌药对足月胎膜早破(PROM)母婴结局的影响。方法:收集我院2015年10月~2017年10月住院分娩的230例足月PROM孕妇的资料进行回顾性分析。根据预防用药距离PROM时间不同分组:以8 h为界分为<8 h组(130例)和≥8 h组(100例);以12 h为界分为<12 h组(194例)和≥12 h组(36例);以18 h为界分为<18 h组(213例)和≥18 h组(17例)。对比各组产前产后观察指标和母婴不良结局发生情况。结果:各组孕妇平均年龄、孕周、初产率等基线资料差异无统计学意义(P>0.05)。<8 h组和≥8 h组孕妇产前产后观察指标及产后母婴结局比较,差异无统计学意义(P>0.05);<12 h组产后新生儿有2例凝血障碍,1例哭声异常,≥12 h组产后1例新生儿为足月小样儿,均非感染患儿;<12 h组产后新生儿脐动脉血pH值高于>12 h组(P<0.05);<18 h组孕妇产前WBC高于≥18 h组,≥18 h组孕妇产后PCT高于<18 h组,<18 h组新生儿转儿科例数高于≥18 h组(P>0.05);其他各项指标差异均无统计学意义(P>0.05)。结论:对于足月PROM孕妇,分娩前可适当推迟抗菌药使用时间。

Objective: To investigate the effects of prophylactic antibiotics used at different times before delivery on the maternal and infant outcomes of term premature rupture of membranes(PROM).Methods: The data of 230 full-term PROM pregnant women who gave birth in our hospital from October 2015 to October 2017 were retrospectively analyzed.The women were divided into different groups according to the different time between preventive medication and premature rupture of membranes.As for 8 h as the time interval,the women were divided into <8 h group(130 cases) and ≥8 h group(100 cases);as for 12 h as the time interval,the women were divided into <12 h group(194 cases) and ≥ 12 h group(36 cases);as for 18 h as the time interval,the women were divided into <18 h group(213 cases) and ≥18 h group(17 cases).The prenatal and postnatal observation indicators and adverse maternal and infant outcomes were analyzed.Results: A total of 230 full-term PROM pregnant women met the research conditions;the average age,gestational age and first delivery rate of pregnant women in each group were not statistically different(all P>0.05);<8 h group and ≥8 h group had no statistically significant differences in the prenatal and postnatal observation indices of pregnant women and the postpartum maternal and infant outcomes(P>0.05);<12 h group had 2 cases of coagulopathy and one case of abnormal crying in newborns;≥12 h group had one postpartum full-term infant,and none of them were infected.The pH value of umbilical artery blood of the newborns in <12 h group was higher than that in ≥12 h group,and the difference was statistically significant(P< 0.05);as for the prenatal WBC,that in <18 h group was higher than that in ≥18 h group,and the postpartum PCT in ≥18 h group was higher than that in <18 h group.The cases transferred to pediatrics in <18 h group(9 cases) were more than those in ≥18 h group(0 cases),the difference was statistically significant(P > 0.05),and there were no statistically significant differences in the other indicators(P >0.05).Conclusion: For pregnant women with full-term PROM,the use of antibiotics can be postponed appropriately before delivery.