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目的探讨足月儿呼吸窘迫综合征(RDS)的危险因素。方法选择2006—2009年本院新生儿科诊断RDS的足月儿为观察组,同期住院未合并RDS的足月儿为对照组。对两组胎龄、出生体重、分娩方式、宫内窘迫、窒息、脐带绕颈、母亲糖尿病、多胎等高危因素进行单因素方差分析和多因素Logistic回归分析。结果 (1)两组胎龄、母亲糖尿病、多胎、脐带绕颈差异无统计学意义(P>0.05),观察组体重低于对照组[(2713±375)g比(2994±473)g],男性比例和剖宫产率高于对照组(73.1%比56.7%,97.0%比66.4%),宫内窘迫率低于对照组(17.9%比31.3%),差异有统计学意义(P<0.05)。(2)多因素Logistic回归分析显示,体重、剖宫产、男性、窒息、宫内窘迫、母亲糖尿病、多胎与足月儿RDS的发生有相关性(P<0.05)。结论剖宫产、男性、窒息、母亲糖尿病是足月儿RDS发生的危险因素,高出生体重、宫内窘迫、多胎是足月儿RDS发生的保护因素。
Objective To investigate the risk factors of full-term respiratory distress syndrome (RDS). Methods Full-term infants diagnosed with RDS in our hospital from 2006 to 2009 were selected as the observation group. Full-term infants without RDS during the same period were selected as the control group. Two groups of risk factors of gestational age, birth weight, mode of delivery, intrauterine distress, asphyxia, cord around the neck, maternal diabetes, multiple births and other risk factors were analyzed by one-way ANOVA and multivariate Logistic regression analysis. Results The body weight of the observation group was lower than that of the control group [(2713 ± 375) g vs (2994 ± 473) g], and there was no significant difference in gestational age, mothers’ diabetes mellitus, (73.1% vs 56.7%, 97.0% vs 66.4%), and the intrauterine distress rate was lower than that of the control group (17.9% vs. 31.3%, P < 0.05). (2) Multivariate logistic regression analysis showed that weight, cesarean section, males, asphyxia, intrauterine distress, maternal diabetes, multiple births and full-term RDS were correlated (P <0.05). Conclusion Cesarean section, males, asphyxia and maternal diabetes are the risk factors of full-term RDS. High birth weight, intrauterine distress and multiple births are the protective factors of full-term RDS.