未足月胎膜早破新生儿早发型败血症的影响因素logistic模型分析

Influencing Factors of Early-onset Septicemia in Newborns with Preterm Premature Rupture of Membranes logistic Model Analysis

目的:通过logistic模型分析未足月胎膜早破(preterm premature rupture of membranes,PPROM)新生儿早发型败血症的影响因素。方法:回顾性分析2020年3月—2023年3月厦门大学附属成功医院出生的130例PPROM新生儿的临床资料。以出生后72 h内是否发生早发型败血症(early-onset sepsis,EOS)为依据,分为EOS组(n=18)、非EOS组(n=112),统计两组的相关资料并进行单因素、多因素分析,探究PPROM新生儿EOS的影响因素。结果:两组孕产妇肥胖、发生胎膜早破时胎龄、Ⅲ~Ⅳ级呼吸窘迫综合征(respiratory distress syndrome,RDS)、出生时低体重、新生儿窒息比较,差异有统计学意义(P<0.05);两组高龄、初产妇、妊娠期糖尿病、妊娠期高血压疾病、宫颈机能不全、胎盘早剥、组织学绒毛膜羊膜炎、产前抗生素治疗比较,差异无统计学意义(P>0.05);两组新生儿性别、娩出方式、预防性应用抗生素比较,差异无统计学意义(P>0.05);多因素logistic回归结果显示,出生时体重(OR=4.402、P=0.018)、Ⅲ~Ⅳ级RDS(OR=2.678、P=0.020)为影响PPROM新生儿发生EOS的危险因素。结论:PPROM新生儿EOS的影响因素与出生时低体重、Ⅲ~Ⅳ级RDS有密切联系,因此,对存在此类高危因素的新生儿,需及时采取有效的针对性干预措施,从而降低发病率及死亡率。

Objective:To analyze the influencing factors of premature septicemia in newborns with preterm premature rupture of membranes(PPROM)by logistic model.Method:A clinical data of 130 PPROM newborns born in Chenggong Hospital Affiliated to Xiamen University from March 2020 to March 2023 were retrospectively analyzed.According to the occurrence of early-onset septicemia(early-onsetsepsis,EOS)within 72 h after birth,the patients were divided into EOS group(n=18)and non-EOS group(n=112).The related data of the two groups were analyzed and univariate and multivariate analysis were conducted to explore the influencing factors of EOS in newborns with PPROM.Result:There were significant differences in maternal obesity,gestational age at premature rupture of membranes,gradeⅢ-Ⅳrespiratory distress syndrome(respiratorydistresssyndrome,RDS),low birth weight and neonatal asphyxia between the two groups(P<0.05).There were no significant differences in advanced age,parturient,gestational diabetes mellitus,hypertensive disorder complicating pregnancy,cervical dysfunction,placental abruption,histological chorioamnionitis and prenatal antibiotic treatment(P>0.05).There were no significant differences in neonatal sex,delivery mode and prophylactic use of antibiotics(P>0.05).The results showed that birth weight(OR=4.402,P=0.018)and gradeⅢ-ⅣRDS(OR=2.678,P=0.020)were risk factors for EOS in newborns with PPROM.Conclusion:The influencing factors of EOS in newborns with PPROM are closely related to low birth weight and gradeⅢ-ⅣRDS at birth.Therefore,timely and effective intervention measures should be taken for newborns with such high risk factors to reduce morbidity and mortality.