常见妊娠并发症与早产低体质量新生儿的相关性研究

Research on the correlation between common pregnancy complications and premature low birth weight newborns

目的:探讨妊娠妇女妊娠并发症与早产低体质量患儿的关系,为临床指导优生优育提供依据。方法:选取广州市花都区妇幼保健院2018年1月1日-2019年12月31日产科住院全部单胎早产孕妇1085例,其中正常体质量早产儿532例,低体质量早产儿553例。所有研究对象以病案第一诊断为统计依据。采用多元logistics回归分析来识别与衡量风险因素,双尾检验,P<0.05为差异有统计学意义。结果:1085例研究对象出生儿胎儿男女比例约为1.42:1,经产与初产研究对象在新生儿体质量之间差异存在统计学意义(P<0.05);前6位与早产低体质量患儿相关的妊娠并发症分别为无乳链球菌(Group B Streptococcus,GBS)感染、心功能不全、妊娠合并高血压、妊娠合并胆汁淤积、羊水量异常以及宫内窘迫;正常体质量早产儿组与低体质量早产儿组研究对象进行妊娠并发症相比较,GBS感染、妊娠合并高血压、羊水量异常差异有统计学意义(P<0.05);早产低体质量患儿危险因素分析显示GBS感染在所有危险因素中排在首位[比值比(Odds Ratio,OR)=2.842],95%置信区间(Confidenfial Interval,CI)1.809-4.469,其次为妊娠合并高血压(OR=2.759,95%CI 1.738-4.378)与羊水量异常(OR=1.646,95%CI 1.031-2.627)。结论:采取有效的策略降低妊娠期GBS感染、高血压及羊水异常等危险因素,对降低早产低体质量新生儿的发生具有重要意义。

Objective:To explore the relationship between pregnancy complications of pregnant women and premature low birth weight infants,and to provide basis for clinical guidance of prenatal and postnatal care.Methods:From January 1,2018 to December 31,2019,1085 pregnant women with preterm births were selected from Guangzhou Huadu Maternal and Child Health Hospital,including 532 normal-weight preterm infants and 553 low-weight preterm infants.All research subjects are based on the first diagnosis of medical records.Multivariate logistic regression analysis was used to identify and measure risk factors,two-tailed test,P<0.05 indicates that the difference was statistically significant.Results:The male-to-fetus ratio of 1085 subjects at birth was about 1.42:1,and there was significant difference in the weight of newborns between maternal and primiparous subjects(P<0.05).The first 6 pregnancy complications associated with preterm low birth weight infants were Streptococcus agalactiae(GBS)infection,cardiac insufficiency,pregnancy with hypertension,pregnancy with cholestasis,abnormal amniotic fluid volume,and intrauterine distress;Comparison was made between normal-weight preterm infants group and low-weight preterm infants group,there were significant differences in GBS infection,pregnancy with hypertension,and abnormal amniotic fluid volume(P<0.05);Analysis of risk factors for low-weight preterm infants group showed that GBS infection ranked first among all risk factors[odds ratio(OR)=2.842],95% confidence interval(CI)1.809-4.469),which was followed by pregnancy with hypertension(OR=2.759,95%CI 1.738-4.378)and abnormal amniotic fluid volume(OR=1.646,95%CI 1.031-2.627).Conclusion:Taking effective strategies to reduce the risk factors of Streptococcus agalactiae infection,hypertension and amniotic fluid during pregnancy is of great significance to reduce the incidence of premature and low birth weight newborns.