产妇围产期内硬膜外麻醉相关发热对新生儿院内感染风险的影响

Effect of Fever Related to Epidural Anesthesia During the Perinatal Period of Parturient on the Risk of Nosocomial Infection in Newborns

目的探讨产妇围产期内硬膜外麻醉镇痛相关发热对新生儿院内感染风险的影响。方法选取2019年1月-12月在我院进行分娩且接受硬膜外麻醉镇痛的产妇237例,根据在生产时体温是否超过38℃分为发热组94例和未发热组143例,分析发热对妊娠结局以及新生儿的影响,对比不同组别新生儿感染情况,探究影响新生儿院内感染的因素。结果产妇硬膜外麻醉相关发热的因素有缩宫素使用、羊水浑浊、分娩麻醉镇痛时间、分娩方式、破膜至分娩时间、第二产程时间(P<0.05);新生儿辅助通气、1、5、10 min Apgar评分与产妇硬膜外麻醉相关发热有关(P<0.05);两组新生儿院内感染情况比较,差异有统计学意义(P<0.05);新生儿发生院内感染相关单因素分析结果显示,羊水浑浊、破膜至分娩时间、产前白细胞总数、产前C反应蛋白、新生儿窒息比较,差异有统计学意义(P<0.05);Logistic回归分析显示,新生儿窒息、破膜至分娩时间、羊水浑浊、产前白细胞总数是新生儿院内感染的独立影响因素(P<0.05),而产前C反应蛋白、硬膜外麻醉镇痛相关发热不是影响新生儿院内感染的独立因素(P>0.05)。结论产妇围产期内硬膜外麻醉相关发热与新生儿院内感染具有相关性,硬膜外麻醉相关发热不会增加新生儿院内感染的风险。

Objective To investigate the influence of fever related to epidural analgesia during the perinatal period of parturients on the risk of nosocomial infection in newborns.Methods A total of 237 parturients who received epidural analgesia during delivery in our hospital from January to December 2019 were selected.According to whether the body temperature exceeded 38℃at the time of delivery,they were divided into 94 cases in the fever group and 143 cases in the non-fever group.To analyze the influence of fever on pregnancy outcome and newborns,compare the infection status of newborns in different groups,and explore the factors affecting the hospital infection of newborn.Results The factors of fever related to maternal epidural anesthesia included oxytocin use,amniotic fluid turbidity,analgesic time during childbirth anesthesia,manner of delivery,time from membrane rupture to delivery,and time for the second stage of labor(P<0.05);Neonatal assisted ventilation,Apgar score at 1,5,and 10 minutes were related to maternal epidural anesthesia-related fever(P<0.05);There was a statistically significant difference in the nosocomial infection of the two groups of newborns(P<0.05);The results of univariate analysis of neonatal hospital infections showed that there were statistically significant differences in amniotic fluid turbidity,time from membrane rupture to delivery,total number of prenatal white blood cells,prenatal C-reactive protein,and neonatal asphyxia(P<0.05);Logistic regression analysis showed that neonatal asphyxia,rupture of membranes to delivery time,amniotic fluid turbidity,and total prenatal white blood cell count were independent influencing factors of neonatal nosocomial infection(P<0.05).Prenatal C-reactive protein and epidural analgesia-related fever were not independent factors affecting neonatal nosocomial infection(P>0.05).Conclusion There is a correlation between epidural anesthesia-related fever and nosocomial infection of newborns during the perinatal period.Epidural anesthesia-related fever does not increase the risk of neonatal nosocomial infection.