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目的探讨自发性早产(spontaneous preterm birth,SPB)合并胎膜早破(premature rupture of membranes,PROM)的诱因及其对母儿结局的影响。方法选取郑州大学第一附属医院2008年3月至2012年3月住院分娩患者的病历资料,287例28~37孕周的SPB合并PROM的孕妇作为观察组,同期住院分娩的119例SPB未合并PROM的孕妇作为对照组。回顾性分析两组妊娠结局的不同,以及影响妊娠结局的诱因。结果观察组新生儿肺透明膜病的发生率显著低于对照组,观察组新生儿除肺透明膜病外其他感染的发生率显著高于对照组,差异均有统计学意义(P<0.05);观察组新生儿出生后Apgar<7分、新生儿窒息、新生儿高胆红素血症、新生儿胎粪吸入综合征、新生儿死亡率较对照组有升高趋势,但差异无统计学意义(P>0.05)。下生殖道感染是PROM最常见的诱因。结论 SPB合并PROM患者比SPB未合并PROM患者的新生儿感染率增加,新生儿肺透明膜病的发生率明显降低,新生儿死亡率比较差异无统计学意义。
Objective To investigate the causes of spontaneous preterm birth (SPB) combined with premature rupture of membranes (PROM) and its effect on the outcomes of both maternal and child. Methods The medical records of hospitalized patients in the First Affiliated Hospital of Zhengzhou University from March 2008 to March 2012 were selected. 287 pregnant women with SPB combined with PROM from 28 to 37 gestational weeks were selected as the observation group. 119 cases of SPB during hospitalization during the same period were not merged PROM pregnant women as a control group. Retrospective analysis of the difference between the two groups of pregnancy outcomes, as well as the factors that affect the outcome of pregnancy. Results The incidence of hyaline membrane disease in observation group was significantly lower than that in control group. The incidence of other infections except hyaline membrane disease in observation group was significantly higher than that in control group (P <0.05) ; The observation group neonatal Apgar <7 points after birth, neonatal asphyxia, neonatal hyperbilirubinemia, neonatal meconium aspiration syndrome, neonatal mortality rate increased compared with the control group, but the difference was not statistically significant Significance (P> 0.05). Lower genital tract infection is the most common cause of PROM. Conclusions The infection rate of neonates with SPB and PROM is higher than that without PROM. The incidence of neonatal hyaline membrane disease is significantly lower than that without PROM. There is no significant difference in neonatal mortality between the two groups.