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目的探讨孕产妇围生期感染的高危因素及其与分娩方式、新生儿感染的相关性。方法选取2016年1-12月该院收治的、符合纳入标准的单胎分娩孕产妇1 500例。根据孕产妇是否有围生期感染高危因素,分为高危组和正常组;根据孕产妇分娩方式分为剖宫产组和自然分娩组;根据胎龄分为早产组和足月组。比较新生儿脐带血IgA、IgG、IgM、C3及C4水平。结果围生期感染的高危因素:早产[OR=2.17,95%CI(1.08,4.36),P=0.03]、羊水污染[OR=0.94,95%CI(1.27,5.14),P=0.01]为新生儿感染的独立危险因素;高危组的IgA、IgM水平明显高于正常组,差异有统计学意义(t=9.12、12.35,P<0.01),而C3水平较低(t=25.94,P<0.01)。剖宫产组的IgG水平明显低于自然分娩组,差异有统计学意义(t=8.42,P<0.01),但IgA、IgM、C3及C4水平差异无统计学意义(P>0.05)。早产组的IgG、C3及C4水平明显低于足月组,差异有统计学意义(t=22.81、17.59、19.49,P<0.01),但IgA、IgM水平差异无统计学意义(P>0.05)。结论围生期感染的高危因素使新生儿脐带血IgA、IgM水平明显升高,与新生儿感染密切相关,而分娩方式对新生儿免疫功能影响较弱,早产儿的免疫功能发育较足月儿不足。
Objective To investigate the risk factors of perinatal infection in pregnant women and its relationship with delivery mode and neonatal infection. Methods From January to December in 2016, 1 500 cases of single-birth pregnant women who met the inclusion criteria were selected. According to whether maternal perinatal infection risk factors, divided into high-risk group and normal group; according to the mode of delivery of pregnant women is divided into cesarean section group and natural delivery group; according to gestational age is divided into preterm group and term group. Neonatal cord blood IgA, IgG, IgM, C3 and C4 levels were compared. Results The risk factors of perinatal infection were as follows: preterm birth [OR = 2.17,95% CI 1.08,4.36, P = 0.03], amniotic fluid contamination [OR = 0.94,95% CI 1.27,5.14, P = 0.01] (T = 9.12,12.35, P <0.01), while the level of C3 was lower (t = 25.94, P <0.01), and the risk of neonatal infection was higher than that of the normal group 0.01). The IgG level in cesarean section group was significantly lower than that in spontaneous delivery group (t = 8.42, P <0.01), but there was no significant difference in IgA, IgM, C3 and C4 levels (P> 0.05). The levels of IgG, C3 and C4 in preterm group were significantly lower than those in term group (t = 22.81,17.59,19.49, P <0.01), but the levels of IgA and IgM were not significantly different (P> 0.05) . Conclusion The risk factors of perinatal infection make the levels of IgA and IgM in neonatal cord blood significantly increased, which are closely related to the neonatal infection. However, the mode of delivery has a weaker impact on the immune function of newborn infants. Compared with full-term infants insufficient.