早产胎膜早破合并孕妇肥胖对≥34周早产儿住院结局的影响

The influence of preterm premature rupture of membranes and pregnant women obesity on hospitalization outcome of 34 weeks or over preterm infants

目的比较早产胎膜早破(PPROM)≥34周的肥胖孕妇与非肥胖孕妇的早产儿住院结局。方法回顾性分析2016年1月—2020年12月在本院出生并入住新生儿科的所有出生胎龄≥34周的PPROM早产儿。根据孕妇分娩时体质量指数(BMI),分为肥胖组(BMI≥30 kg/m^(2))和非肥胖组(BMI<30 kg/m^(2)),比较2组间的一般情况、妊娠结局及所生晚期早产儿的住院结局,组间比较采用两独立样本t检验及χ2检验。结果与非肥胖孕妇相比,肥胖孕妇的晚期早产儿分娩后呼吸道并发症发病率高,主要表现为新生儿呼吸窘迫综合征,辅助通气、吸氧和表面活性物质的使用、败血症、感染性肺炎发病率高,母亲妊娠期糖尿病发病率增高,差异均具有统计学意义(P<0.05),其余新生儿高胆红素血症、新生儿坏死性小肠结肠炎、脑室内出血、早产儿支气管肺发育不良等并发症比较无统计学意义(P>0.05)。结论PPROM≥34周的肥胖孕妇与非肥胖孕妇相比,所生晚期早产儿呼吸道并发症和败血症等不良结局的发生率增加。

Objective To compare the hospitalization outcomes of 34 weeks or over preterm infants with preterm premature rupture of membranes(PPROM)in obese and non-obese pregnant women.Methods A retrospective analysis of PPROM preterm infants born in our hospital and admitted to the neonatology department from January 2016 to December 2020 with a gestational age of 34 weeks or over was carried out.According to the pregnant women s body mass index(BMI)at delivery,they were divided into obese group(BMI≥30 kg/m^(2))and non-obese group(BMI<30 kg/m^(2)).The general conditions,pregnancy outcomes and late premature infants hospitalization outcomes between the two groups were compared using two independent samples t test andχ^(2)test.Results Compared with non-obese pregnant women,the incidence of respiratory complications after delivery in late preterm infants of obese pregnant women was higher,mainly manifested as high incidence of neonatal respiratory distress syndrome,assisted ventilation,oxygen inhalation and the use of surfactants,sepsis,and pneumonia,also maternal gestational diabetes incidence was increased,and the differences were statistically significant(P<0.05);other complications of neonatal hyperbilirubinemia,necrotizing enterocolitis,intraventricular hemorrhage,bronchopulmonary dysplasia were not statistically significant(P>0.05).Conclusions Compared with non-obese pregnant women with 34 weeks or over PPROM,obese pregnant women had an increased incidence of adverse outcomes in late preterm infants such as respiratory complications and sepsis.