目的 分析胎膜早破新生儿感染的发生状况并探索影响其发生的危险因素.方法 回顾性选取2020年5月—2023年5月泉州市第一医院新生儿科收治的580例新生儿的临床资料,按照新生儿有无发生感染而分为感染组(n=61)和未感染组(n=519).收集产妇住院期间及新生儿的临床记录作为基线资料,使用多因素Logistic回归分析新生儿感染的危险因素.结果 在所有的胎膜早破新生儿中,共有10.52%(61/580)的新生儿出现感染,其中呼吸系统感染的新生儿占比45.90%(28/61),血液系统感染新生儿占比19.67%(12/61),皮肤软组织感染新生儿占比11.48%(7/61),泌尿系统感染新生儿占比9.84%(6/61),其他部位感染新生儿占比13.11%(8/61).两组新生儿出生胎龄、出生体重、胎膜早破时间、出生1 min Apgar评分、新生儿血白细胞总数、新生儿血中性粒细胞绝对值、产妇血白细胞总数、产妇血中性粒细胞绝对值、分娩方式、有无羊水污染、产妇B族链球菌检测是否阳性、产妇有无预防性使用抗菌药物、破膜距离胎儿娩出时间、产妇产前有无心动过速及产妇有无合并绒毛膜羊膜炎等资料对比,差异有统计学意义(P均<0.05).新生儿出生时的胎龄<37周、新生儿出生体重<2500 g、新生儿出生1 min Apgar评分<8分、剖宫产、产妇存在羊水污染、B族链球菌检测阳性及合并有绒毛膜羊膜炎均为胎膜早破新生儿感染发生风险的独立危险因素(P均<0.05).结论 胎膜早破新生儿发生感染的独立影响因素包括新生儿出生胎龄<37周、新生儿出生体重<2500 g、新生儿出生1 min Apgar 评分<8分、剖宫产、产妇羊水污染、产妇B族链球菌检测阳性及产妇合并绒毛膜羊膜炎等,在临床工作中应重点监测以上指标,对高危新生儿进行有针对性的预防及治疗,进而降低新生儿的感染风险.
Analysis of the Incidence and High-risk Factors of Infection in Newborns with Premature Rupture of Membranes
Objective To analyze the incidence of infection in newborns with premature rupture of membranes and ex-plore the risk factors affecting its occurrence.Methods The clinical data of 580 neonates admitted to the Neonatology Department of Quanzhou First Hospital from May 2020 to May 2023 were retrospectively selected.According to the presence or absence of infection,the neonates were divided into infection group(n=61)and non-infection group(n=519).The clinical records of maternal hospitalization and neonates were collected as baseline data,and multivariate Logistic regression was used to analyze the risk factors of neonatal infection.Results Among all neonates with prema-ture rupture of membranes,a total of 10.52%(61/580)of neonates were infected,including 45.90%(28/61)of neo-nates with respiratory system infection,19.67%(12/61)of neonates with hematologic infection,11.48%(7/61)of neo-nates with skin and soft tissue infection,9.84%(6/61)of neonates with urinary tract infection,and 13.11%(8/61)of neonates with infection from other sites.There were significant differences between the two groups in gestational age,birth weight,premature rupture of membranes,Apgar score at 1 min after birth,total number of white blood cells in neonatal blood,absolute value of neutrophils in neonatal blood,total number of white blood cells in maternal blood,absolute value of neutrophils in maternal blood,mode of delivery,presence or absence of amniotic fluid contamination,positive detection of group B streptococcus in maternal blood,presence or absence of prophylactic use of antibiotics in maternal blood,time from rupture of membranes to delivery of fetus,presence or absence of tachycardia in maternal blood and presence or absence of chorioamnionitis in maternal blood(all P<0.05).Gestational age at birth<37 weeks,neonatal birth weight<2500 g,Apgar score<8 points at 1 min after birth,cesarean section,maternal presence of am-niotic fluid contamination,positive detection of group B streptococcus and chorioamnionitis were all independent risk factors for neonatal infection in premature rupture of membranes(all P<0.05).Conclusion The independent influenc-ing factors for infection in newborns with premature rupture of membranes include gestational age<31 weeks,birth weight<2500 g,Apgar score<8 points at 1 min after birth,vaginal delivery,amniotic fluid contamination in parturi-ents,negative detection of Group B streptococci in parturients,and concurrent chorioamnionitis in parturients.In clini-cal practice,the above indicators should be closely monitored to provide targeted prevention and treatment for high-risk newborns,thereby reducing the risk of infection in newborns.
Premature rupture of membranesNewbornInfectedRisk factors
万方数据
维普
