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目的探讨围生期高危因素对胎儿窘迫、新生儿窒息的影响,以采取有效预防措施降低新生儿的致残率和死亡率。方法回顾性分析2012年12月-2016年12月在重庆巿綦江区人民医院分娩的11 500例产妇的临床资料,其中发生胎儿窘迫、新生儿窒息的产妇800例作为观察组,同期未出现胎儿窘迫、新生儿窒息的产妇10 700例作为对照组。对比两组产妇年龄、孕周、分娩史、分娩方式、胎膜早破、胎盘异常、24 h尿蛋白量、妊娠期高血压疾病、孕期贫血、羊水异常、出生体重、婴儿性别、胎心率异常、脐带异常、产程过长等发生情况,分析围生期高危因素与胎儿窘迫、新生儿窒息的相关性。结果围生期发生胎儿窘迫、新生儿窒息的高危因素为高龄、孕周<30周、有分娩史、胎膜早破、胎盘异常、24 h尿蛋白量≥3 g/24 h、妊娠期合并症、羊水异常、出生低体质量儿、胎心率异常、脐带异常、剖宫产、产钳助产、产程延长(P<0.05)。结论完善产前指导,提高产前检查质量,加强对围生期高危因素的监护及处理,可有效降低胎儿窘迫、新生儿窒息的发生率。
Objective To investigate the impact of perinatal risk factors on fetal distress and neonatal asphyxia, in order to take effective preventive measures to reduce neonatal morbidity and mortality. Methods The clinical data of 11 500 mothers giving birth in Qijiang District People’s Hospital of Chongqing Municipality from December 2012 to December 2016 were retrospectively analyzed. Among them, 800 cases of fetal distress and neonatal asphyxia were regarded as the observation group and no fetus occurred during the same period Distress, neonatal asphyxia 10,700 mothers as a control group. Comparison of two groups of maternal age, gestational age, delivery history, mode of delivery, premature rupture of membranes, placental abnormalities, 24 h urine protein, gestational hypertension, anemia during pregnancy, amniotic fluid abnormality, birth weight, infant sex, fetal heart rate Abnormalities, umbilical cord abnormalities, labor and other long cases of occurrence, analysis of perinatal high risk factors and fetal distress, neonatal asphyxia correlation. Results Perinatal fetal distress, neonatal asphyxia risk factors for the elderly, gestational age <30 weeks, with delivery history, premature rupture of membranes, placental abnormalities, 24 h urinary protein levels ≥ 3 g / 24 h, pregnancy combined Symptoms, abnormal amniotic fluid, low birth weight children, abnormal fetal heart rate, abnormal umbilical cord, cesarean section, forceps midwifery, prolonged labor (P <0.05). Conclusion Perfecting prenatal guidance, improving the quality of prenatal examination and strengthening the guardianship and handling of risk factors in perinatal period can effectively reduce the incidence of fetal distress and neonatal asphyxia.