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目的探讨晚期早产儿中发生小于胎龄儿(SGA)的围产期因素及新生儿期患病特点。方法对2009年10月至2010年9月在我院新生儿重症监护病房住院、胎龄34～36周的晚期早产儿临床资料进行回顾性分析,比较晚期早产儿中SGA和适于胎龄儿(AGA)的围产期因素及新生儿期患病情况。结果 SGA组(179例)住院天数明显长于AGA组(851例)[(16.4±6.2)天比(11.3±4.1)天,P<0.05]。SGA组母亲妊娠期高血压疾病(HDCP)、多胎妊娠、羊水过少和宫内窘迫的比例均高于AGA组(34.1%比17.9%,29.1%比13.7%,21.2%比12.6%,19.6%11.0%,P均<0.01)。SGA组患儿新生儿窒息、喂养不耐受、颅内出血、低血糖和红细胞增多症的发生率亦明显高于AGA组(12.8%比7.9%,7.8%比3.1%,6.1%比2.6%,27.4%比21.4%,3.4%比0.2%,P均<0.05)。结论母亲HDCP和多胎妊娠是造成晚期早产儿SGA的主要原因,SGA患儿相对于AGA患儿具有更高的患病风险,应针对造成SGA的围产期因素以及新生期疾病特点进行相应预防和干预。
Objective To investigate the perinatal factors and neonatal morbidity in young preterm infants with small gestational age (SGA). Methods From October 2009 to September 2010 in our hospital neonatal intensive care unit hospitalized, gestational age 34 to 36 weeks of late preterm children clinical data were retrospectively analyzed, compared with late preterm children SGA and suitable for gestational age children (AGA) perinatal factors and neonatal morbidity. Results The length of stay in the SGA group (179 cases) was significantly longer than that in the AGA group (851 cases) (16.4 ± 6.2 days vs 11.3 ± 4.1 days, P <0.05). The proportion of HDCP, multiple pregnancies, oligohydramnios and intrauterine distress in the SGA group was higher than those in the AGA group (34.1% vs. 17.9%, 29.1% vs. 13.7%, 21.2% vs. 12.6%, 19.6% 11.0%, P <0.01). The incidence of neonatal asphyxia, feeding intolerance, intracranial hemorrhage, hypoglycemia and polycythemia in SGA group was also significantly higher than that in AGA group (12.8% vs 7.9%, 7.8% vs 3.1%, 6.1% vs 2.6% 27.4% vs. 21.4%, 3.4% vs. 0.2%, P <0.05). Conclusions Mothers HDCP and multiple pregnancy are the main causes of SGA in advanced preterm infants. SGA children have a higher risk of disease than those with AGA. Therefore, appropriate measures should be taken to prevent perinatal factors and newborn disease caused by SGA Intervention.