Risk Factors for Birth Asphyxia in Togo: A Case-Control Study

Background: Birth Asphyxia (BA) is one of the leading causes of neonatal death in developing countries. In Togo, 30.55% of neonatal deaths were related to BA and caused by several risk factors. The purpose of this piece of work is to analyse the antepartum, intrapartum, and foetal risk factors of BA. Methods: This is a case control study, conducted from 1st December 2019 to 28th February 2020 in obstetrics wards and at neonatal intensive care of paediatric ward at the Sylvanus Olympio university teaching hospital (CHU-SO) in Lomé, Togo. Neonates diagnosed with BA (Apgar score < 7 at 5th minute) were considered as “cases” (N = 200) while neonates born either with normal vaginal delivery or by cesarean section having no abnormality were considered as “control” (N = 200). Results: The prevalence rate of BA was 9.13%. Age (p = 0.0391), gravidity (p = 0.0040), type of facility for prenatal follow-up (p < 0.0001), use of Long-lasting impregnated mosquito nets (LLIN) (p < 0.0001), notion of maternal fever (p < 0.0001) and chronic pathology (p < 0.0001) were related to occurrence of BA. Significant antepartum risk factors observed were age < 25 years (OR = 1.15;CI 95% [0.66 - 1.98], p = 0.0391), primigravidity (OR = 1.82;95% CI [0.86 - 3.85], 0.0040), prenatal follow-up in a private one (OR = 1.62;CI95% [1.03 - 12.55], p < 0.0001), non-use of LLIN (OR = 2.50;CI 95% [1.61 - 3.88], p < 0.0001), maternal fever (OR = 3.73;CI 95% [2.33 - 5.97], p < 0.0001) and existence of maternal chronic pathology (OR = 36.0, 95% [4.94 - 262.60], p < 0.0001). Significant intrapartum risk factors were PRM (OR = 7.89;CI 95% [2.62 - 14.02], p < 0.0001), abnormal AF (OR = 5.40;CI 95% [2.57 - 11.38],], p < 0.0001), long labour (OR = 2.11;CI 95% [1.34 - 3.34],], p = 0.0004), use of oxytocin (OR = 2.14;CI 95% [1.38 - 3.32], p = 0.0003), and spontaneous vaginal (OR = 1.76;CI 95% [1.14 - 2.72,], p = 0.0008]). Significant Foetal risk factors were male gender (OR = 1.55;CI 95% [1.03 - 2.33], p = 0.0423), preterm babies (OR = 8.83;CI 95% [3.79 - 20.60], p < 0.0001) and baby birth weight < 2500 gr (OR = 2.96;CI 95% [1.82 - 4.79], p < 0.0001). The Sarnat score had shown anoxo-ischemic encephalopathy stage III (19.00%), corresponding to 87.80% of case fatality rate (p < 0.0001). Conclusion: Various risk factors lead to BA in Lomé. Early identification of high-risk cases with improved antenatal and perinatal care can decrease the high mortality of BA in Togo.

Evaluation of utilization of antenatal services by mothers of babies with severe birth asphyxia

Objective:To evaluate the utilization of antenatal services by mothers of babies delivered with severe birth asphyxia at the University of Port Harcourt Teaching Hospital(UPTH) Port Harcourt,Nigeria.Methods: A case control study of the utilization of antenatal services by 97 mothers of newborns with severe birth asphyxia delivered at UPTH from 1st February to 31st October 2009 compared with mothers of newborns with normal Apgar scores was done.Relevant pregnancy,birth,family and social history was obtained by personal interviews and referral to case notes.Results: Significantly more of the mothers of babies with normal Apgar score booked early(4 months or less) and had up to 8 or more antenatal visits prior to delivery than mothers of asphyxiated babies 86(88.6%) vs 68(70.2%),P=0.002;93(95.7%) vs 68(70.2%),P=0.001 respectively.Significantly more subjects 56(57.7%) than the controls 45(46.4%) were primiparous,P= 0.04.Also,significantly more subjects 19(19.5%) suffered delay prior to intervention in labour than the controls 5(5.1%),P=0.004.Conclusion: Primiparity,delayed booking,inadequate antenatal visits and late intervention in labour have been identified as significant contributors to severe birth asphyxia.

Associative Factors for Birth Asphyxia at Queen Elizabeth Central Hospital—Malawi

Background: Birth asphyxia is one of the major causes of neonatal deaths worldwide. Queen Elizabeth Central Hospital (QECH) neonatal ward records indicate that 36.5% of neonates admitted in the ward from April to September 2012 had birth asphyxia. This study was conducted to explore associative factors for birth asphyxia at QECH. Methodology: The study design was descriptive cross sectional that employed quantitative methods of data collection and analysis. Data sources were case notes of neonates and their mothers.? Sample size was 87 neonates with birth asphyxia and 87 neonates admitted with conditions other than birth asphyxia as controls. Data were collected from November to December 2013. Statistical Package for Social Science (SPSS) version16.0 was used to analyze data. Results: Findings revealed that there were no maternal associative factors for birth asphyxia, however, foetal distress, prolonged first and second stage of labour were significant associative factors for birth asphyxia. Conclusion: Associative factors for birth asphyxia at QECH are Foetal distress, prolonged first and second stage of labour. These factors can be prevented if quality care is provided to women in labour through close monitoring of foetal heart, appropriate use of the partograph, prompt decision making and early interventions.

Risk Factors Associated with Birth Asphyxia in Rural District Matiari, Pakistan: A Case Control Study

Background: During the past two decades there has been a sustained decline in child mortality;however, neonatal mortality has remained stagnant. Each year approximately 4 million babies are born asphyxiated resulting in 2 million neonatal deaths and intrapartum stillbirths. Almost all neonatal deaths occur in developing countries, where the majority is delivered at homes with negligible antenatal care and poor perinatal services. Objectives: To identify socio-demographic and clinical risk factors associated with birth asphyxia in Matiari District of Sindh Province, Pakistan. Method: A matched case control study was conducted in Matiari District with 246 cases and 492 controls. Newborn deaths with birth asphyxia diagnosed through verbal autopsy accreditation during 2005 and 2006 were taken as cases. Controls were the live births during the same period, matched on area of residence, gender and age. Result: The factors found to be associated with birth asphyxia mortality in Matiari District of Sindh Province, Pakistan are maternal education, history of stillbirths, pregnancy complications (including smelly or excessive vaginal discharge and anemia), intrapartum complications (including fever, prolong or difficult labour, breech delivery, cord around child’s neck, premature delivery, large baby size) and failure to establish spontaneous respiration after birth. Conclusion and Recommendation: There is an immediate need to develop strategies for early identification and management of factors associated with birth asphyxia by involving women, families, communities, community health workers, health professionals and policy makers. Community health workers should be trained for emergency obstetric care, basic newborn care including preliminary resuscitation measures to provide skilled birth attendance and encourage early recognition and referral.

Midwives’ adherence to guidelines on the management of birth asphyxia in Malawi

A study was conducted to determine midwives adherence to guidelines on management of birth asphyxia at Queen Elizabeth Central Hospital in Blantyre district, Malawi. The study design was descriptive cross sectional using quantitative data analysis method on 75 midwives that were working in the maternity unit of the hospital. A structured questionnaire was used to collect data on participant’s demographic characteristics and midwives’ comprehension of birth asphyxia and an observational check list was used to observe midwives’ adherence to WHO resuscitation guidelines. In addition midwives were observed on their adherence to the Integrated Maternal and Neonatal Health guidelines that were developed by the Malawi Ministry of Health. The findings indicate that the midwives had knowledge of birth asphyxia in general. However, there were gaps in their ability to identify warning signs of birth asphyxia through partograph use. In addition the midwives did not adhere to 9 out of the 21 steps of the resuscitation guideline. Generally there was substandard adherence to guidelines on identification of warning signs of birth asphyxia and neonatal resuscitation. On the other hand, the facility did not have adequate resuscitation equipment and supplies. The results are discussed in relation to the importance of adhering to resuscitation guidelines in the management of birth asphyxia for babies that do not breathe at birth. Training of the midwives on partograph use and resuscitation to improve neonatal outcomes is recommended. It is recommended further that the health facility should have adequate resuscitation equipment and supplies.

Risk factors of clinical birth asphyxia and subsequent newborn death following nuchal cord in a low-resource setting

Introduction: Our aim was to identify the risk factors of clinical birth asphyxia and subsequent newborn death in the presence of nuchal cord in a sub-Saharan Africa setting. Methodology: It was a six-months’ case-control study involving 117 parturients whose babies presented with a nuchal cord at delivery. The study was carried out at the Yaoundé Gyneco-Obstetric and Pediatric Hospital, Cameroon, from January 1st to June 30th 2013. Results: The risk factors of clinical birth asphyxia identified were: first delivery, absence of obstetrical ultrasound during pregnancy, nuchal cord with more than one loop, duration of second stage of labor more than 30 minutes during vaginal delivery. The risk factors for newborn death from clinical birth asphyxia in the presence of nuchal cord were: maternal age Conclusion: We recommend a systematic obstetrical ultrasound before labor, so as to detect the presence of a nuchal cord, its tightness and the number of loops. Also, cesarean section should be considered when a nuchal cord is associated with first delivery, tightness or multiple looping.

1990-2019年中国出生窒息/创伤所致新生儿脑病疾病负担分析

目的分析1990—2019年我国出生窒息/创伤所致新生儿脑病的疾病负担水平及其变化趋势。方法从2019年全球疾病负担研究数据库中提取1990—2019年我国出生窒息/创伤所致新生儿脑病的伤残调整寿命年(disability-adjusted life years,DALY)、DALY率、死亡人数、死亡率、危险因素等数据。采用Joinpoint回归分析计算死亡率和DALY率的年度平均百分比变化(annual average percentage change,AAPC)以及95%置信区间(confidence interval,CI)。结果2019年我国出生窒息/创伤所致新生儿脑病死亡率为1139.527人/10万,DALY率为101275.239人年/10万,与1990年相比,均下降了76.23%。其中,男性和女性新生儿的死亡率分别为1230.738人/10万、1033.004人/10万,DALY率分别为109381.824人年/10万、91807.766人年/10万;0~6 d和7~28 d新生儿的死亡率分别为4022.626人/10万、178.166人/10万,DALY率分别为357481.444人年/10万、15844.063人年/10万。1990—2019年出生窒息/创伤所致新生儿脑病死亡率和DALY率的AAPC均为-4.88[95%CI(-5.17,-4.59)]。小于胎龄儿、早产、环境颗粒污染物和固体燃料燃烧的家庭污染是我国出生窒息/创伤所致新生儿脑病的主要危险因素。结论相较于1990年,2019年我国出生窒息/创伤所致新生儿脑病死亡率、DALY率均呈下降趋势,出生早期男性儿童的疾病负担高于女性儿童,因此应针对小于胎龄儿、早产、环境颗粒物污染、固体燃料燃烧的家庭污染等危险因素制定政策,继续重视孕期保健服务,以期进一步降低出生窒息/创伤所致新生儿脑病的疾病负担。

自动娩肩法对降低巨大儿肩难产发生率的临床研究

目的探讨自动娩肩法对降低巨大儿肩难产发生率的临床疗效。方法选取2020年1月至2021年6月赣州市妇幼保健院收治的60例巨大儿分娩产妇作为研究对象,随机分为对照组与研究组,每组30例。照组采用传统的接生方法,研究组采用自动娩肩法,比较两组产妇的肩难产发生率、产妇产道损伤、新生儿产伤率。结果研究组肩难产发生率低于对照组,差异有统计学意义(P<0.05)。研究组新生儿窒息率低于对照组,差异有统计学意义(P<0.05)。研究组新生儿产伤发生率低于对照组,差异有统计学意义(P<0.05)。结论自动娩肩法可有效减低巨大儿分娩产妇肩难产的发生,避免产妇产道损伤、新生儿窒息及产伤等情况发生,具有临床应用价值。

新生儿窒息的相关危险因素分析及Nomogram模型的构建

目的:分析新生儿窒息的相关危险因素,并构建Nomogram预测模型。方法:回顾性分析2020年5月—2022年4月于医院分娩的230例新生儿临床资料,根据是否发生窒息分为观察组(n=11)和对照组(n=219)。对两组的临床资料进行统计分析,通过受试者工作特征(ROC)曲线分析有统计学意义的连续性变量;采用多元Logistic回归模型分析新生儿窒息的独立危险因素;R软件构建预测新生儿窒息的Nomogram预测模型;校正曲线对Nomogram预测模型进行内部验证;决策曲线评估模型的临床净收益。结果:观察组产妇年龄高于对照组;早产儿比例、胎位异常比例、产妇异常妊娠史比例、胎膜早破比例、产妇先兆流产史比例、初产比例和产妇妊娠期高血压比例高于对照组(均P<0.05)。产妇年龄曲线下面积(AUC)是0.829,最佳截断值是35岁。产妇年龄(≥35岁)、早产儿、胎位异常、初产和产妇妊娠期高血压是新生儿窒息的独立危险因素(P<0.05)。结论:本研究基于产妇年龄、早产儿、胎位异常、初产和产妇妊娠期高血压构建了新生儿窒息危险因素的Nomogram预测模型,有助于医护人员认识窒息相关高危因素,制定个性化护理对策,为临床防治提供参考。

Risk Factors for Perinatal Asphyxia in Newborns Delivered at Term

Perinatal asphyxia is defined as harm to the fetus or the newborn caused by hypoxia and/or ischemia of various organs with intensity to produce biochemical and/or functional changes. Understanding the risk factors for this clinical condition allows the identification of vulnerable groups, enabling an improvement in care planning in the perinatal period in neonatal intensive care units. In this sense, this research aimed to identify risk factors for perinatal asphyxia present in newborns term that showed record for this clinical condition. This was a cross-sectional, retrospective documentary, quantitative and descriptive, conducted from data from medical records of 55 infants admitted to a neonatal intensive care unit. As for maternal characteristics (78.0%) had between 16 and 35 years, only one child (53.0%) and (76.0%) had no prior history of miscarriage. As for pre-existing diseases or pregnancy (38.0%) developed by Hypertensive Pregnancy Specific disease (02.0%) were suffering from Hypertension and (02.0%) of Diabetes Mellitus. As for newborns, most infants had birth weight (43.6%) and correlation with gestational age (78.2%) compatible for good conditions of birth. Only (20.0%) of the infants had a difficult labor. It stood out although there was a slight predominance of severe asphyxia (50.9%) in the first minute and (45.5%) of the infants had record release intrauterine meconium. It was concluded that most mothers and newborns did not have risk factors for perinatal asphyxia, thus, this fact could be attributed to the structural conditions of service, especially in the care during labor, delivery and immediate assistance newborn.

北京市通州区2016年至2020年新生儿出生健康状况评价

目的评估近年北京市通州区新生儿出生健康状况,为改善围生期保健提供依据。方法收集2016年至2020年在北京市通州区妇幼保健院出生的新生儿资料,对新生儿出生健康状况做描述性分析,并与该院10年前(2010年)数据及2005年中国城市新生儿出生状况数据(简称2005年全国数据)进行比较分析。结果2016年1月至2020年12月分娩活产新生儿共50222名,男女性别比为1.06:1;足月儿占94.59%,早产儿占5.41%,无过期产儿;自然分娩占57.58%,剖宫产占42.42%;新生儿窒息发生率占0.34%,明显低于2005年全国数据(4.80%)(U=-46.757,P<0.05)。新生儿出生体重中位数为[3370(3090,3660)]g,其中早产儿出生体重中位数为[2510(2140,2870)]g,足月儿出生体重中位数为[3400(3130,3680)]g,均低于10年前(2010年)数据(Z值分别为-14.464、-11.010、-16.940,P<0.001)。低出生体重儿的比例(3.70%)较10年前(2010年)数据(2.49%)增加,巨大儿的比例(8.12%)较10年前(2010年)数据(12.10%)下降(U值分别为17.402、-27.347,P<0.001)。小于胎龄儿(SGA)的比例占4.91%,明显低于2005年全国数据(6.61%)(U=-15.334,P<0.001);大于胎龄儿(LGA)的比例(12.24%)明显低于10年前(2010年)数据(28.75%)(U=-81.749,P<0.001)。新生儿母亲中位年龄为[30(28,33)]岁,母亲年龄>35岁的早产儿占18.99%(516/2717),明显高于足月儿的15.40%(7314/47505)(χ^(2)=25.243,P<0.001);母亲为辅助生殖受孕的早产儿占5.48%(149/2717),明显高于足月儿的1.44%(685/47505)(χ^(2)=257.120,P<0.001)。结论2016年至2020年北京市通州区新生儿出生健康状况较10年前(2010年)数据明显改善,并优于2005年全国数据,但仍需进一步提高孕期保健,加强产、儿科合作,保证新生儿健康水平。

极低/超低出生体重儿生后1 min低Apgar评分的危险因素:多中心回顾性研究

目的探讨极低/超低出生体重儿生后1 min低Apgar评分(≤7分)的危险因素。方法回顾性收集2018年1月-2019年12月江苏省新生儿重症监护病房母乳喂养质量改进临床研究协作组多中心临床数据库极低/超低出生体重儿的临床资料。按生后1 min Apgar评分分为低Apgar评分组(Apgar评分≤7分)和正常Apgar评分组(Apgar评分>7分)。采用多因素logistic回归分析法探讨生后1 min低Apgar评分的影响因素。采用受试者操作特征曲线(receiver operating characteristic curve,ROC曲线)分析评价相关指标对生后1 min低Apgar评分的预测价值。结果纳入1809例极低/超低出生体重儿。1 min低Apgar评分发生率为52.90%(957/1809)。多因素logistic回归分析显示:胎龄越大,患儿出现1 min低Apgar评分的风险越小(OR=0.853,P<0.05);出生体重越大,患儿出现1 min低Apgar评分的风险越小(OR=0.999,P<0.05);羊水异常的患儿出现1 min低Apgar评分的风险较高(OR=1.646,P<0.05);产前使用糖皮质激素的患儿出现1 min低Apgar评分的风险较低(OR=0.502,P<0.05)。ROC曲线分析显示,胎龄、出生体重、羊水异常和产前使用糖皮质激素4个指标联合预测出现1 min低Apgar评分的灵敏度为0.554,特异度为0.680。结论低胎龄、低出生体重、羊水异常可增加极低/超低出生体重儿生后1 min低Apgar评分的风险,产前积极使用糖皮质激素有利于降低生后1 min低Apgar评分的风险。

新生儿血小板减少症发生状况及影响因素

目的分析新生儿血小板减少症(NTP)发生状况及影响因素。方法前瞻性随机试验选取2019年5月至2020年5月于上蔡县人民医院出生的新生儿365例作为研究对象。采用问卷调查方式收集所有新生儿及产妇资料(新生儿性别、胎龄、出生体质量、剖宫产方式、产妇合并疾病、宫内感染情况),统计新生儿NTP发生状况,并重点分析可导致NTP发生的影响因素。结果365例新生儿中,24例新生儿发生NTP,发生率为6.58%,341例未发生NTP,未发生率为93.42%。NTP发生不受新生儿性别、宫内生长迟缓、分娩方式、产妇合并疾病影响,差异无统计学意义(P>0.05);但可能受出生体质量、胎龄、宫内感染、新生儿窒息、血小板相关免疫球蛋白M(PA-IgM)阳性的影响,差异有统计学意义(P<0.05)。经单因素Logistic回归分析结果显示,出生体质量<1500 g、早产儿、有宫内感染、新生儿窒息、PA-IgM阳性是导致NTP发生的影响因素,差异有统计学意义(OR>1,P<0.05);经多元Logistic回归分析,结果显示,出生体质量<1500 g、早产儿、PA-IgM阳性是导致NTP发生的影响因素,差异有统计学意义(OR>1,P<0.05)。结论出生体质量<1500 g、早产儿、有宫内感染、新生儿窒息、PA-IgM阳性均可能诱导NTP,临床可根据上述因素制定相应的干预方案以降低NTP的发生。

703例水中分娩对新生儿窒息的影响分析

目的:了解水中分娩是否会增加新生儿窒息的风险。方法:纳入从2012年4月至2013年3月在四川省妇幼保健院水中分娩的703例产妇(其中水中待产153例,水中生产550例)作为研究组,同期常规分娩无妊娠合并症、并发症足月单胎头位产妇658例作为对照组。比较研究组和对照组间新生儿窒息及严重呼吸并发症的发生情况。结果:研究组703例水中分娩共有13例发生新生儿窒息,发生率为1.8%(13/703),其中水中待产组有5例(3.3%,5/153),根据Apgar评分有1例为重度窒息,其余均为轻度窒息;水中生产组有8例(1.5%,8/550)新生儿窒息,均为轻度。对照组658例常规分娩发生新生儿窒息的有6例,均为轻度,发生率为0.9%。研究组新生儿窒息发生率高于对照组,但差异无统计学意义(P>0.05)。水中待产组新生儿窒息发生率高于水中生产组,但差异也无统计学意义(P>0.05)。水中待产组1例重度窒息使用了经鼻持续气道正压通气(NCPAP),水中生产组有2例窒息新生儿发生严重的胎粪吸入综合征,使用呼吸机辅助通气。结论:水中分娩可能会增加新生儿窒息的发生率,但本研究差异无统计学意义,尚需扩大样本进一步研究。

1995年苏州地区双胎妊娠结局分析

【目的】分析出生指标,评价双胎妊娠结局。【方法】采用1995年苏州地区围产保健监测资料,比较单、双胎孕周、出生体重、Apgar评分、新生儿死亡率及死亡原因。【结果】双胎妊娠中早产儿占35.0%;低出生体重儿占4 9.2%;1 min和5 min Apgar评分窒息者分别占1 3.9%和5.6%;各指标均显著高于单胎。双胎新生儿死亡率为45.9‰;早期新生儿死亡率42.8‰;新生儿主要死亡原因为早产。【结论】与单胎儿相比,双胎妊娠胎儿宫内发育时间、发育状况、产后适应能力等均明显偏差,新生儿死亡率显著偏高。应采用多种干预措施,改善双胎妊娠不良结局。

早产儿肾功能特点及影响因素

早产儿肾功能不成熟,出生后早期由于受母体肌酐水平的影响及肾小管功能不成熟,其血清肌酐水平是增高的;肾小球滤过率低,在某些病理情况下易发生肾衰竭;肾小管功能差,易发生水电解质紊乱和酸碱平衡失调。早产儿出生后最初几周,肾功能经历了一个快速成熟的时期,并受胎龄、药物、营养、宫内发育情况、出生体质量等因素的影响。

北京市新生儿期保健服务与常见疾病变化趋势分析

目的:了解北京市新生儿期保健服务及新生儿期常见疾病的变化趋势。方法:对北京市1996～2003年8年的新生儿管理情况进行分析。结果:北京市新生儿访视服务覆盖率逐年增高,2003年达93.89%,从访视方式构成看,“代访信”访视比例逐年增加;新生儿纯母乳喂养率保持在85%左右,新生儿满月增重合格(≥600g)率一直保持在99%以上;北京市高危新生儿发生率呈逐年增加的趋势,低出生体重、窒息、肺炎位居新生儿期常见疾病的前3位。结论:新生儿“代访信”制度有利于提高新生儿访视率,低出生体重、窒息、肺炎是目前影响新生儿健康的主要问题。

重庆市妇幼保健院16年新生儿出生情况对比分析

目的通过对本院1992和2008年分娩的新生儿的调查,同时与2005年全国新生儿流行病学调查资料进行对比分析,了解我市目前新生儿出生情况和这16年来的发展变化及与全国新生儿出生情况的差别。方法对本院1992年及2008年产科分娩所有活产新生儿,资料采用SPSS 13.0软件对两组新生儿性别、出生体重、胎龄、孕产次、Apgar评分、分娩时情况及母亲年龄等数据进行统计分析。结果(1)1992年组与2008年组新生儿男女性别比分别为1.01∶1和1.04∶1,无明显差异;(2)两组在胎龄构成、出生体重、窒息发生率、母亲生产次数、母亲年龄分布上有显著差异。结论(1)早产儿发生率明显增加;(2)不同胎龄新生儿出生体重变化明显;(3)新生儿窒息发生率明显下降;(4)社会因素剖宫产率明显增加。

新生儿窒息与出生缺陷关系的临床研究

目的探讨新生儿窒息与出生缺陷的关系。方法对近8年我院收治的新生儿窒息患儿进行出生缺陷的检查及探讨窒息与出生缺陷的关系,并调查TORCH感染与出生缺陷的关系。结果159例新生儿窒息中有出生缺陷41例,占25.78%,41例中有TORCH感染证据的21例,占51.20%。结论出生缺陷是新生儿窒息的病因之一,而宫内感染亦是引起出生缺陷的重要病因,预防宫内感染及致畸因素是减少新生儿窒息重要手段。

地西泮联合阿托品对产程的干预作用及新生儿的影响

目的探讨地西泮联合阿托品对产程的干预作用以及对新生儿的影响。方法选取2013年1月至12月医院住院分娩的健康足月产妇136例,按随机数字表法分为观察组和对照组,各68例。研究组于产妇潜伏期宫口开大2 cm时先静脉注射地西泮10 mg,0.5 h后再静脉滴注催产素2.5 U,按宫缩的强弱程度调节催产素滴速,当活跃期宫口开大5 cm时静脉注射阿托品0.5 mg;对照组仅于产妇潜伏期宫口开大2 cm时静脉滴注催产素2.5 U。结果观察组产妇第一产程所需时间为(372.61±124.51)min、总产程为(447.32±103.62)min,分别短于对照组产妇的(562.53±136.23)min和(639.74±135.94)min(P<0.05);观察组产妇阴道分娩率为91.17%,显著高于对照组的77.94%(P<0.05);两组产妇产后出血量无统计学差异(P>0.05);观察组新生儿窒息及胎心异常情况的发生率显著低于对照组(P<0.05)。结论地西泮联合阿托品可有效缩短产程、提高阴道分娩率,避免新生儿窒息,值得临床推广。