摘要
目的:探讨晚期早产儿(胎龄34 周至 36+6 周)新生儿呼吸窘迫综合征(NRDS)合并新生儿急性呼吸窘迫综合征(ARDS)的高危因素.方法:回顾性分析2019 年9 月至2023 年1 月某院新生儿重症监护病房住院治疗的晚期早产儿NRDS病例为研究对象.根据是否发生ARDS分为观察组(NRDS合并ARDS组)和对照组(单纯NRDS组),对两组的围产期高危因素进行对比分析.结果:研究对象共92 例,其中观察组44 例、对照组48 例.两组在性别、胎龄、体重、分娩方式的差异无统计学意义(P>0.05).观察组妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素D缺乏、羊水粪染、窒息发生率高于对照组,差异具有统计学意义(P<0.05).两组妊娠期糖尿病、妊娠期高血压、产前促肺治疗、胎膜早破、脐带缠绕、前置胎盘、胎盘早剥、低体重、宫内窘迫的发生率无统计学意义(P>0.05).将单因素分析中有统计学意义的变量(妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素D缺乏、羊水粪染、窒息)纳入到Logistics回归分析中,经逐步Logistics回归分析妊娠晚期呼吸道感染(OR=9.613,95%CI 1.056-87.489,P<0.05);妊娠晚期阴道炎(OR=11.469,95%CI 1.286-102.294,P<0.05);妊娠晚期维生素D缺乏具有统计学意义(OR = 7.499,95%CI 1.887-29.802,P<0.05),与晚期早产儿 NRDS 合并ARDS的关联均有统计学意义.结论:妊娠晚期呼吸道感染、妊娠晚期阴道炎、妊娠晚期维生素 D 缺乏是晚期早产儿NRDS合并ARDS的独立危险因素.
Abstract
Objective:To investigate the perinatal risk factors for late preterm neonatal respiratory dis-tress syndrome(NRDS)with acute respiratory distress syndrome(ARDS).Methods:A retrospective analy-sis was conducted on cases of late preterm NRDS admitted to the neonatal intensive care unit of a certain hos-pital from September 2019 to January 2023.The patients were divided into the observation group(NRDS with ARDS)and the control group(simple NRDS)according to whether or not they developed ARDS.The perina-tal risk factors of the two groups were compared.Results:A total of 92 cases were included,with 44 cases in the observation group and 48 cases in the control group.There were no significant differences in sex,gesta-tional age,body weight,and mode of delivery between the two groups(P>0.05).The incidence of late-term respiratory tract infection,late-term vaginitis,late-term vitamin D deficiency,meconium-stained amniotic fluid,and asphyxia was higher in the observation group than in the control group,with statistically significant differences(P<0.05).The incidence rates of gestational diabetes,gestational hypertension,prenatal lung stimulation therapy,premature rupture of membranes,umbilical cord entanglement,placenta previa,placen-tal abruption,low body weight,and intrauterine distress revealed no statistical significance in both groups(P>0.05).The variables with statistical significance in the univariate analysis(late-term respiratory tract infec-tion,late-term vaginitis,late-term vitamin D deficiency,meconium-stained amniotic fluid,and asphyxia)were included in the logistic regression analysis.The results of the stepwise logistic regression analysis showed that late-term respiratory tract infection(OR=9.613,95%CI 1.056-87.489,P<0.05),late-term vaginitis(OR=11.469,95%CI 1.286-102.294,P<0.05),and late-term vitamin D deficiency(OR=7.499,95%CI 1.887-29.802,P<0.05)were all statistically significant,and were associated with late preterm NRDS with ARDS.Conclusion:Late-term respiratory tract infection,late-term vaginitis,and late-term vitamin D deficiency are independent risk factors for late preterm NRDS with ARDS.
基金项目
河北省医学科学研究重点课题指令性计划项目(20160017)
维普
万方数据