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目的探讨早产儿母亲相关危险因素对早产儿早发型败血症发病的影响。方法选择我院新生儿科2013年9月至2014年8月确诊或临床诊断早发型败血症的早产儿为病例组,同期入住未并发败血症的早产儿为对照组。分析两组患儿母亲存在的危险因素及其与早产儿早发型败血症之间的关系。结果病例组82例,对照组365例。病例组经血培养确诊35例,临床诊断47例;其中母亲有胎膜早破34例,临床绒毛膜羊膜炎17例,B组溶血链球菌(GBS)定植35例,胎盘早剥19例。单因素分析显示出生胎龄<33周、产时发热≥38℃、胎膜早破>18h、胎儿心动过速>160次/min、绒毛膜羊膜炎、孕34周直肠阴道GBS培养阳性、先兆子痫、胎盘早剥、流产病史与早产儿早发型败血症的发生有关(P<0.05)。Logistic回归分析显示,胎膜早破>18 h(OR=9.176,95%CI 4.253~19.932)、绒毛膜羊膜炎(OR=9.291,95%CI 4.364~21.671)、孕34周直肠阴道GBS培养阳性(OR=25.803,95%CI 5.912~112.613)、胎盘早剥(OR=5.860,95%CI 1.859~18.467)为早产儿早发型败血症的独立危险因素。结论胎膜早破>18 h、绒毛膜羊膜炎、孕34周直肠阴道GBS培养阳性、胎盘早剥为早产儿早发型败血症的独立危险因素。
Objective To investigate the impact of maternal risk factors on the incidence of early-onset sepsis in premature infants. Methods Preterm infants with confirmed or clinically diagnosed early-onset sepsis were selected as the case group from September 2013 to August 2014 in our hospital. In the same period, premature infants without septicemia were included as control group. To analyze the risk factors of mothers in the two groups and its relationship with premature infant premature sepsis. Results 82 cases of cases, control group of 365 cases. In the case group, 35 cases were confirmed by blood culture and 47 cases were diagnosed clinically. Among them, 34 cases were premature rupture of membranes, 17 cases were chorioamnionitis, 35 cases were colonized by GBS and 19 cases were placental abruption. Univariate analysis showed that the gestational age at birth <33 weeks, the onset of fever ≥ 38 ℃, premature rupture of membranes> 18h, fetal tachycardia> 160 beats / min, chorioamnionitis, 34 weeks pregnant with rectal vaginal GBS culture positive, Pre-eclampsia, placental abruption, and the history of miscarriage were associated with the occurrence of early-onset sepsis in preterm infants (P <0.05). Logistic regression analysis showed that the premature rupture of membranes was> 18 h (OR = 9.176, 95% CI 4.253-19.932), chorioamnionitis (OR = 9.291, 95% CI 4.364-21.671) (OR = 25.803, 95% CI 5.912-112.613), and placental abruption (OR = 5.860,95% CI 1.859-18.467) were independent risk factors for premature infant premature sepsis. Conclusion Premature rupture of membranes> 18 h, chorioamnionitis, rectal vaginal GBS in 34 weeks of pregnancy positive, placental abruption is an independent risk factor for early-onset sepsis in preterm infants.