摘要
目的:通过不同类型的重度子前期(severe preeclampsia,S-PE)早产和自发早产的对比分析,探讨影响S-PE早产结局的相关因素。方法:将重度子前期(研究组)早产72例(早产儿83例),按不同孕周分为早期早产、中型早产及轻型早产3类,分别与相同类型的自发早产(对照组)222例(早产儿279例)进行孕产妇及围生儿结局对比分析。结果:研究组及对照组3类型间的早产儿病死率差异有显著性(P=0.000)。研究组与对照组同类型间早产儿病死率比较,差异无显著性(P>0.05);研究组早期早产儿平均出生体重明显低于对照组(P=0.003),而早产儿并发症发生率与对照组比较,差异无显著性(P>0.05);研究组中的中型早产新生儿除重度窒息明显高于对照组外(P=0.022),新生儿平均出生体重、新生儿轻度窒息率、新生儿病死率及新生儿加强护理NICU(neonatel intensive care unit,NICU)住院日和住院费两组间差异无显著性;在轻型早产组,除研究组NICU住院日明显长于对照组外(P=0.000),两组间其他观察指标的差异均无显著性。多元回归分析显示,早产的分娩孕龄是影响重度子前期早产儿死亡的主要因素;促胎肺成熟和孕期检查是影响新生儿病率的主要因素。结论:不论重度子前期早产还是自发早产,在早期早产阶段影响围生儿预后的主要因素是分娩孕龄,重度子前期早产与自发早产围生结局无明显差异。
Objective： To investigate the related factors of maternal and neonatal outcomes in severe preeclampsia （ S - PE） preterm birth by comparison of S - PE preterm birth with spontaneous preterm birth. Methods： A comparison study was conducted among 72 cases of S - PE preterm birth （83 livebom infants） and 222 cases of spontaneous preterTn birth （279 livebom infants） from 28 to 36 weeks of gestation. Cases were divided into three stages according to gestational age as very early preterTn birth, moderate early preterTn birth, and mild early preterTn birth. Results. The neonatal mortality rates were significant different among three stages within two groups respectively. There was no difference in the neonatal mortality rate between these two groups at each same stage. In very early preterrn birth, the average birth weight of study group was much lower than the control group （P=0.003）, but the neonatal morbidity was no difference in two groups. In moderate early preterTn birth, the rate of severe neonatal asphyxia was higher in study group than that in controls. In mild early preterTn birth, the duration of NICU hospitalization was longer in study groups than that in control ones. Multivariate Logistic regression analysis showed that gestational age at birth was the major factor affecting neonatal mortality in S- PE. Conclusions, This study suggested that perinatal outcomes were closely related to gestational age at birth. There was no difference in perinatal outcomes between S- PE and spontaneous preterm birth.
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2005年第11期663-667,共5页
Journal of Practical Obstetrics and Gynecology
关键词
早产
重度子痈前期
围生结局
Preterrn birth
Severe pre-eclampsia
Perinatal outcome
