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目的分析晚期早产的高危因素及不同分娩方式对新生儿预后的影响。方法回顾性分析2013年1月至2014年6月在内蒙古医科大学附属医院住院分娩的胎龄34~40周的孕妇及其新生儿的临床资料,根据分娩孕周将其分为晚期早产组(34~36周)738例,足月分娩组(37~40周)4 380例,分析晚期早产的高危因素及不同分娩方式对新生儿预后的影响。结果 (1)二元Logistic回归分析显示,晚期早产的高危因素为妊娠期高血压疾病、瘢痕子宫、前置胎盘、胎盘早剥、胎膜早破。(2)经剖宫产分娩的新生儿转入新生儿监护病房(neonatal intensive care unit,NICU)率明显高于顺产分娩儿(P<0.05)。(3)晚期早产儿中,剖宫产分娩儿转入NICU率、高胆红素血症发生率、呼吸窘迫综合征(respiratory distress syndrome,RDS)发生率明显高于顺产分娩儿(P<0.05);足月儿中,剖宫产分娩儿转入NICU率、高胆红素血症、RDS及感染性疾病发生率明显高于顺产分娩儿(P<0.05)。结论晚期早产与足月分娩高危因素存在差异,剖宫产分娩儿多种疾病的发生率比顺产分娩儿高,故应依据胎龄采取相应措施,尽量选择阴道分娩。
Objective To analyze the risk factors of advanced preterm labor and the effects of different modes of delivery on the prognosis of newborns. Methods The clinical data of pregnant women and their newborns with gestational age of 34-40 weeks who were hospitalized and delivered in the Affiliated Hospital of Inner Mongolia Medical University from January 2013 to June 2014 were retrospectively analyzed. According to the gestational weeks of childbirth, they were divided into the late preterm group ( 34 to 36 weeks), 738 cases of full-term delivery group (37 to 40 weeks) 4 380 cases, analysis of the risk factors of advanced preterm delivery and different delivery methods on the prognosis of newborns. Results (1) Binary logistic regression analysis showed that the risk factors of advanced preterm birth were hypertensive disorders of pregnancy, uterine scar, placenta previa, placental abruption and premature rupture of membranes. (2) The neonatal intensive care unit (NICU) rate of newborns delivered through cesarean section was significantly higher than that of normal delivery (P <0.05). (3) The incidence of NICU, hyperbilirubinemia, and respiratory distress syndrome (RDS) were significantly higher in cesarean section than in cesarean section in advanced preterm infants ); Term infants, cesarean delivery into NICU rate, hyperbilirubinemia, RDS and infectious disease incidence was significantly higher than that of childbirth (P <0.05). Conclusions The risk factors of late delivery and term delivery are different. The incidence of multiple diseases in cesarean delivery is higher than that of normal delivery. Therefore, we should take appropriate measures according to gestational age to choose vaginal delivery as far as possible.