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目的明确胎膜早破(PROM)与足月新生儿呼吸窘迫综合征(RDS)的相关性。方法采用病例对照研究的方法,选择2008年1月-2010年12月出生后在本院新生儿重症监护中心住院、胎龄在37周以上、诊断为RDS的患儿205例为病例组,同期入院、主要诊断为新生儿黄疸(除外感染因素所致者)的410例足月新生儿为对照组。对所有纳入对象的临床资料进行回顾性分析,记录相关信息,包括有无PROM、患儿性别、分娩方式、出生体质量、羊水污染等,探讨PROM与足月儿RDS的关系。结果 1.RDS组RPOM所占比例(30.2%,62/205例)明显高于对照组(15.5%,63/410例),差异有统计学意义(χ2=12.276,P<0.001)。2.经单因素分析,PROM、选择性剖宫产、男性、小于胎龄儿、羊水量少、妊娠期血糖偏高及糖尿病、羊水Ⅲ度污染、宫内窘迫、出生时窒息等因素均与足月儿RDS具有相关性(Pa<0.05),均为RDS的危险因素,而孕母年龄≥35岁、脐带绕颈、胎盘早剥与RDS均无相关性(Pa>0.05)。3.经Logistic回归分析:PROM、选择性剖宫产、男性、妊娠期血糖异常及糖尿病、出生时窒息等与足月儿RDS密切相关。结论 PROM与足月儿RDS密切相关,是足月儿RDS的高危因素之一。
Objective To clarify the correlation between premature rupture of membranes (PROM) and neonatal respiratory distress syndrome (RDS). Methods A case-control study was conducted in our hospital from January 2008 to December 2010 after birth, neonatal intensive care center hospitalized in our hospital, gestational age of 37 weeks or more, 205 cases diagnosed as RDS cases of patients as the case group, the same period Admission, the main diagnosis of neonatal jaundice (caused by factors other than infection) of 410 full-term newborns as a control group. The clinical data of all the patients were retrospectively analyzed, and the relevant information, including whether or not PROM, gender, mode of delivery, birth weight and amniotic fluid contamination were recorded. The relationship between PROM and full-term RDS was explored. Results 1. The proportion of RPOM in RDS group (30.2%, 62/205 cases) was significantly higher than that in control group (15.5%, 63/410 cases), the difference was statistically significant (χ2 = 12.276, P <0.001). By univariate analysis, PROM, selective cesarean section, male, less than gestational age, less amniotic fluid, high blood sugar and gestational diabetes, amniotic fluid degree of Ⅲ degree of pollution, intrauterine distress, birth asphyxia and other factors are Full-term infants with RDS were correlated (Pa <0.05), all of which were risk factors for RDS. However, there was no correlation between RDS and pregnant women ≥35 years of age (P> 0.05). Logistic regression analysis: PROM, selective cesarean section, male, gestational blood sugar abnormalities and diabetes, birth asphyxia and so on are closely related with full-term RDS. Conclusions PROM is closely related to RDS in term infants and is one of the risk factors of RDS in term infants.