新鲜周期卵裂胚和囊胚移植单胎分娩的新生儿结局及影响因素

目的分析新鲜周期体外受精(IVF)-胚胎移植治疗中移植卵裂胚和囊胚后单胎分娩的新生儿结局及其影响因素。方法回顾性分析2014年1月至2016年6月郑州大学第三附属医院生殖医学中心接受IVF/卵胞浆质内单精子注射(ICSI)助孕单胎分娩的1 371例不孕症患者的临床资料及分娩新生儿信息,根据移植胚胎体外培养时间将患者分为囊胚组(n=181例)和卵裂胚组(n=1 190例),比较2组新生儿的早产率、出生体质量、出生缺陷等指标,并对新生儿主要观察指标影响因素进行分析。结果囊胚组早产(PTB)比例高于卵裂胚组(P <0. 05); 2组剖宫产比例、分娩孕周及极早产儿、低出生体质量儿、极低出生体质量儿、大于胎龄儿(LGA)、小于胎龄儿(SGA)及出生缺陷比例比较差异均无统计学意义(P> 0. 05)。Logistic回归分析显示,囊胚移植及母亲年龄与新生儿PTB相关(P <0. 05),不孕类型、产次、母亲体质量指数与LGA有关(P <0. 05),母亲体质量指数与SGA有关(P <0. 05)。结论新鲜周期囊胚移植可增加新生儿PTB发生率,不孕症患者的体质量指数是影响新生儿出生体质量的一个重要因素。     

单脐动脉100例临床分析

目的 探讨单脐动脉的围产期结局. 方法比较我院2007-07-01～2009-12-31间分娩的100例单脐动脉妊娠患者与同期分娩的妊娠患者31 315例(对照组)的妊娠高危因素,并进行统计学分析. 结果 单脐动脉组中,早产16例(16%),剖宫产73例(73%)、胎儿生长受限7例(7%)、新生儿畸形8例(8%)、胎死宫内4例(4%);对照组中,早产1 873例(5.98%),剖宫产14 691例(46.91%)、胎儿生长受限394例(1.26%)、新生儿畸形1 015例(3.24%)、胎死宫内47例(0.15%).合并单脐动脉的妊娠的早产率、剖宫产率、胎儿生长受限发生率、畸形发生率、胎死宫内发生率均明显高于同期妊娠,差异均有统计学意义(P<0.05). 结论单脐动脉为高危妊娠,孕期应除外胎儿畸形可能,密切监测胎儿生长.     

IVF-ET出生的新生儿状况分析

目的对通过体外受精一胚胎移植（IVF-ET）技术受孕出生的新生儿进行评估，探讨实施IVF-ET技术的安全性。方法对2000年10月～2004年12月在本院接受IVF-ET治疗后受孕181例孕妇进行前瞻性追踪观察，将其分娩的254例新生儿作为观察组，本院产科同期自然妊娠分娩的1205例新生儿作为对照组，对两组单胎和总体新生儿孕周、出生体质量、Apgar评分、高胆红素血症、新生儿窒息率、新生儿病死率及新生儿畸形率等进行观察比较。结果除观察组单胎新生儿窒息率与对照组比较差异有显著性外（X^2=6．48，P＜0．05），其他指标与对照组比较差异均无显著性（t’=0．22～1．44，x^2=0．00～1．88，P＞0．05）。两组总体新生儿极低出生体质量发生率、畸形率、窒息率、病死率比较差异无显著性（X^2=0．30～3．56，P＞0．05）；两组总体新生儿孕周、Apgar评分、平均出生体质量、低出生体质量儿发生率、高胆红素血症发生率、住院治疗率等比较，差异有显著性（t’=4．02～12．18，X^2=8．26～59．97，P＜0．01、0．05）。结论IVF-ET技术不增加新生儿畸形率和围生期病死率；多胎是IVF-ET技术主要并发症，是早产、低体质量出生儿、高胆红素血症、窒息等新生儿不良结局的主要原因。     

1237例胚胎移植术后母儿的围产结局分析

目的 回顾性分析西南医院生殖医学中心1 237例胚胎移植术后母儿的围产结局.方法 收集整理2011年1月至2014年7月在我中心行体外受精/卵胞浆内单精子显微注射(in vitro fertilization/intracytoplasmic sperm injection,IVF/ICSI)助孕技术成功妊娠的孕妇1 237例(助孕组),其中鲜胚移植周期711例,冻融胚胎移植周期(frozen thawed embryo transfer,FET)526例,以同期我院收治的自然妊娠孕妇(5040例)作为对照,分组比较母亲围产期情况及新生儿出生结局.结果 助孕组年龄为(30.4±4.2)岁,明显高于对照组(P＜0.05);助孕组多胎率及剖宫产率较对照组明显升高(P＜0.05);助孕组孕周及新生儿平均体质量较对照组明显偏小(P＜0.05);助孕组妊娠期高血压(pregnancy-induced hypertension,PIH)、前置胎盘、妊娠期肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)、产后出血、母亲入ICU、新生儿住院、低体质量儿、早产以及新生儿入ICU(neonatal ICU,NICU)发生率较对照组明显升高(P＜0.05),而胎盘早剥、胎膜早破(premature rupture of fetal membranes,PROM)、先兆子痫、死胎、新生儿死亡及新生儿畸形的发生率两组比较差异无统计学意义.在助孕组内,鲜胚组孕周及新生儿体质量较FET组小(P＜0.05),鲜胚组ICP、PROM和产后出血的发生率较FET低,低体质量儿出生率较FET高(P＜0.05),而PIH、前置胎盘、先兆子痫、胎盘早剥、母亲入ICU、死胎、新生儿死亡、新生儿住院、新生儿畸形、NICU以及早产的发生率两组间比较差异无统计学意义.结论辅助生殖助孕者的PIH、前置胎盘、ICP、产后出血、母亲入ICU、新生儿住院、低体质量儿、早产以及NICU的发生率较自然妊娠孕妇高.     

620例体外受精-胚胎移植后单双胎妊娠结局比较

目的 分析620例体外受精-胚胎移植(IVF-ET)助孕治疗妊娠的结局.方法 采用电话询问、短信、门诊随诊等方式进行随访.结果 IVF临床妊娠率43.10%,单胎妊娠流产、出生缺陷、宫外孕发生率分别为18.81%、1.58%、3.56%,双胎妊娠流产、出生缺陷、宫外孕发生率分别为12.17%、1.74%、0%.双胎妊娠早产、低体重儿发生率分别为44.35%、7.82%,单胎妊娠早产、低体重儿发生率分别为5.94%、0.99%.单双胎妊娠者足月分娩率分别为70.10%、41.74%.单双胎妊娠在流产、出生缺陷、宫外孕发生方面差异无统计学意义(P＞0.05);双胎妊娠早产、低体重儿比单胎妊娠明显增加(P＜0.05),单胎妊娠足月分娩高于双胎妊娠(P＜0.05).结论 加强对IVF-ET助孕者妊娠结局的分析和评估,有助于规范ART技术、保证孕妇及胎儿健康,为减胎术的开展提供依据.     

609个周期体外受精-胚胎移植的并发症与结局

目的总结了体外受精-胚胎移植(IVF-ET)治疗周期的主要并发症及其发生率。方法统计分析了609个IVF-ET治疗周期导致的卵巢过度刺激综合征(OHSS)、异位妊娠、流产、新生儿出生缺陷率、单胎与双胎的分娩结局以及IVF术后患者月经恢复情况。结果OHSS发生率为3.45%;妊娠219例,其中异位妊娠12例,流产38例,引产2例,活产111例,死胎3例,53例仍在继续妊娠之中;新生儿出生缺陷率为1.99%;单胎儿平均出生体重比双胎儿重,早产发生率和低体重儿发生率为双胎儿组高(P=0.000);月经的恢复受药物降调节影响,而与年龄、治疗方案无关。结论我院建立的IVF-ET体系是安全、有效的。     

体外受精母亲与子代健康状况分析

目的:分析体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)受孕母亲和子代的健康状况,为完善辅助生殖技术提供参考.方法:回顾性分析浙江大学医学院附属妇产科医院2001年1月1日-2002年12月31日210例IVF-ET母亲和子代的健康状况,并与同时期同医院自然妊娠分娩者比较.结果:IVF-ET母亲与子代的多胎妊娠率、妊娠期高血压发病率、剖宫产率、早产率、低(和极低)体重儿出生率、子代畸形率均高于自然妊娠者,分别为33.33%和1.72%、10.87%和4.59%、89.85%和65.57%、24.64%和6.27%、25.68%和8.23%、3.83%和1.17%(均P<0.01);妊娠期高血压发病率、早产率、低(和极低)体重儿出生率均与多胎发生率有关,危险因素(OR)、95%可信区间(CI)分别是3.49、1.16～10.50,13.65、5.39～34.58,14.91、5.53～40.17.常规IVF和胞浆内单精子注射技术子代结局的差异无统计学意义(P>0.05),早产与足月产子代学龄前期身高、体重的差异亦无统计学意义(P>0.05).结论:辅助生殖技术可增加多胎的发生率,并使妊娠期高血压、早产儿、低(和极低)出生体重儿的发生率增加.     

超声引导下经阴道多胎妊娠减胎术后妊娠结局分析

目的 分析行多胎妊娠减胎术患者的妊娠结局情况。方法 回顾性分析2009年1月至2019年9月期间63例多胎妊娠孕妇在我院经阴道减胎术的临床资料,根据患者减胎类型不同将患者分为四组:四胎减为双胎组、三胎减为双胎组、三胎减为单胎组、双胎减为单胎组,分析各组患者减胎术后妊娠结局情况。结果 实行减胎术的63例患者中,有50例成功分娩,早期流产3例(4.67%),晚期流产9例(14.29%),因胎儿唇裂行引产术1例(1.59%),足月产37例(58.73),早产13例(20.63%),低体质量儿率43.53%。多胎减为双胎的两组间以及多胎减为单胎的两组间早期流产、早产、新生儿体重、低体质量儿率等差异无统计学意义。与多胎减为单胎组相比,多胎减为双胎组新生儿体质量低,P＜0.05,而两组间早期流产率、晚期流产率、早产率、低体质量儿率等均无统计学差异。结论 多胎妊娠减胎术后妊娠结局可能与最终妊娠数相关,而与最初妊囊数关系不大,多胎减至双胎组较多胎减为单胎组有较高的并发症发生,因此建议接受多胎妊娠减胎术的患者减至单胎妊娠。     

拮抗剂方案中的排卵延迟对体外受精-胚胎移植妊娠结局的影响

目的 分析体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)新鲜周期,拮抗剂方案对胚胎移植妊娠结局的影响.方法 回顾性分析北京妇产医院生殖医学中心2015年进行体外受精、新鲜胚胎移植的149周期,分析拮抗剂方案中的排卵延迟对IVF-ET的妊娠结局的影响.按照是否用拮抗剂分为2组,其中拮抗剂方案组共83个周期,非拮抗剂方案组共66个周期.结果 非拮抗剂方案组分娩孕周及单胎新生儿体重显著低于拮抗剂方案组(P值分别为0.022、0.010),而2组中双胎低体重儿体重、双胎高体重儿体重、双胎新生儿平均体重差异均无统计学意义(P值分别为0.927、0.754、0.839).非拮抗剂方案组孕早期B超胎囊数、胎心数、临床妊娠率、活产率、剖宫产率、早产率、胎停育率均显著高于拮抗剂组(P值分别为0.000、0.002、0.000、0.019、0.039、0.009、0.024).结论 IVF-ET中拮抗剂方案引起的排卵延迟并未增加早产、胎停育、新生儿低体重等不良妊娠结局的发生率.     

142例新生儿窒息分析与围产期保健

目的了解伦教镇新生儿窒息发病情况及与孕周,分娩方式,出生体重的关系,更好地开展围产期保健工作。方法对伦教镇2D02年10月-2004年10月共142例新生儿窒息进行整理分析。结果新生儿窒息发生率为8.2%,早产儿(22.7%)明显高于足月儿(6.5%),低出生体重儿(20.7%)明显高于正常体重儿(7.6%),异常分娩明显高于顺产,其中臀牵引发生率最高,为35.7%。结论进一步加强围产期保健,预防早产、低体重儿的出生,适当放宽臀位产的剖宫产指征,可有效降低新生儿窒息的发病率和死亡率。     

IVF与ICSI周期实验室及临床结果观察

目的比较常规体外受精-胚胎移植(IVF-ET)与卵胞浆内单精子注射(ICSI)两种助孕技术的临床妊娠结局及产科结局。方法对843个IVF-ET及ICSI治疗周期的流产、异位妊娠、多胎妊娠的发生率及新生儿出生体重、胎儿孕龄、先天性畸形的情况进行回顾性分析;并对两组单胎、双胎妊娠的结局分别进行比较。结果ICSI组的受精率显著高于IVF组,IVF和ICSI两组早期胚胎的发育情况、产科结局、围生情况及出生后婴儿的健康情况差异无显著性(P>0·05)。但是双胎妊娠和单胎妊娠两组低体重儿、小于胎龄儿、早产的发生率之间有显著性差异,双胎妊娠组低体重儿、小于胎龄儿、早产的发生率均明显高于单胎妊娠组(P<0·05)。结论IVF与ICSI两组的妊娠结局、围生儿结局相似;ICSI不增加胎儿畸形率及新生儿并发症几率,双胎妊娠是引起低体重儿、小于胎龄儿及早产的主要原因。     

Profile of Live-born Infants of In-vitro Fertilisation

Introduction

The Army Hospital (R&R) is the only service hospital providing in-vitro fertilisation (IVF) facility. Neonatal characteristics of live-born infants at this centre over a two-year period are analyzed in this study.

Methods

Data on 504 consecutive live-born IVF infants over a two-year period (01 Feb 2007 to 31 Jan 2009) were analysed.

Result

Of the 504 neonates, 190 (37.7%) were born by vaginal delivery, 156 (30.9%) by elective lower segment cesarean section (LSCS) and 127 (25.19%) following emergency LSCS. Maternal illness posing specific risk to the neonate was present in 165 out of 504 (32.7%). There were 239 (47.4%) preterm neonates. Males formed 51.8% of the cohort. Singletons accounted for 51.2%, while the rest (48.8%) were products of twin pregnancies. Small for gestational age neonates formed 22.6% (n = 114). A total of 20 (3.9%) infants had congenital malformations. There were 242 (48.1%) low birth weight neonates. A total of 128 (25.4%) neonates needed neonatal intensive care. Of the 504, there were 474 (94.1%) survivors while 30 (5.9%) did not survive. Twenty-nine (6.1%) neonates required readmission during the neonatal period.

Conclusion

In our setting, neonates born following IVF appeared to be at increased risk of prematurity, multiple births and low birth weight. Proper obstetric and neonatal management can result in good neonatal outcomes.Key Words: In-vitro fertilisation, Live-births, Low birth weight     

Predictors of mortality in very low birth weight neonates in India

INTRODUCTION: Very low birth weight (VLBW) neonates constitute approximately 4-7 percent of all live births and their mortality is very high. The objective of the present study was to determine the predictors of mortality in VLBW neonates. METHODS: A retrospective cohort of VLBW neonates admitted over three years was studied. Exclusion criteria were: (1) neonates weighing less than 500 g and with gestational age less than 26 weeks; (2) presence of lethal congenital malformations; and (3) death in the delivery room or within 12 hours of life. The outcome measure was in-hospital death. Medical records were reviewed and data was analysed. Univariate analysis and logistic regression analysis were done to determine the predictors of mortality. RESULTS: A total of 260 cases were enrolled, of which a total of 96 (36.9 percent) babies died. The survival rate was found to increase with the increase in birth weight and gestational age. Univariate analysis showed maternal per vaginal bleeding, failure to administer steroid antenatally, Apgar score less than or equal to 5 at one minute, apnoea, gestational age, neonatal septicaemia and shock are the factors directly responsible for neonatal mortality. Logistic regression equation showed maternal bleed (1.326), apnoea (3.159), birth weight (0.037), gestational age (0.063), hypothermia (1.132) and shock (3.49) predicted 65 percent of mortality in VLBW babies. CONCLUSION: Common antenatal and perinatal predictors of mortality in VLBW infants in India include maternal bleed, failure to administer antenatal steroids, low Apgar score, apnoea, extreme prematurity, neonatal septicaemia and shock.     

Perinatal outcomes among children born by assisted reproductive techniques—a hospital-based case control study

Background

Widespread use of assisted reproductive techniques (ART) has raised major concern about the outcome of resulting pregnancies, as well as about the health of the newborn children. The ART conceived pregnancies have an increased risk for prematurity and low birth weight (LBW). The risk of congenital malformations among children conceived via ART is contemplated to be high. The present case control study was conducted with an aim of analysing perinatal outcomes of children born by ART in the Indian context.

Methods

The case control study was conducted in the Army Hospital (Research and Referral), New Delhi. It included 82 cases and 164 controls. The data was collected on maternal and newborn characteristics among cases and controls. Perinatal outcomes were compared between ART conceived and spontaneously pregnant women in terms of birth weight, preterm, multiple pregnancies, and neonatal complications.

Results

Significant difference was observed in terms of the preterm delivery, birth weight, neonatal complications between the cases and the controls. The adjusted odds ratio (OR) was 21.6 (95% confidence interval [CI] 4.3, 112.9) for preterm delivery; 6.0 (95% CI 1.1, 43.8) for multiple pregnancy and 3.2 (95% CI 1.5, 7.0) for caesarean section. The risk of LBW and neonatal complications was heavily confounded by preterm delivery and multiple pregnancies, the adjusted OR being 0.9 and 1.0, respectively.

Conclusion

Increased risk of preterm delivery, multiple pregnancies and caesarean section was associated with ART. The LBW was confounded by preterm delivery and multiple pregnancies.     

基于前瞻性队列研究体外受精-胚胎移植对不良妊娠结局的影响

目的：评价体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)技术本身是否会增加子代不良妊 娠结局(adverse pregnancy outcomes,APOs)的风险。方法：选择诊断为不孕症通过IVF-ET受孕的妇女为暴露组,诊断为 不孕症但通过非辅助生殖技术治疗(如促排卵或简单药物治疗)后自然怀孕的妇女作为非暴露组,建立前瞻性队列。 通过单因素分析找出两组除IVF-ET操作因素外存在差异的因素,再采用多因素logistic回归分析控制这些因素,分析 IVF-ET技术对APOs的独立作用。结果：多因素logistic回归分析显示,在控制混杂因素后,IVF-ET受孕孕妇较诊断为 不孕症但自然受孕孕妇显著增加早产(OR=1.28,95% CI：1.05~1.56)、低出生体重(OR=1.69,95% CI：1.27~2.31)、围 生期死亡(OR=5.33,95% CI：2.44~11.81)和先天畸形(OR=1.83,95% CI：1.12~2.94)的风险。结论：IVF-ET操作因素本 身可能会增加APOs的风险。     

Perinatal outcomes among children born by assisted reproductive techniques—a hospital-based case control study

Background

Widespread use of assisted reproductive techniques (ART) has raised major concern about the outcome of resulting pregnancies, as well as about the health of the newborn children. The ART conceived pregnancies have an increased risk for prematurity and low birth weight (LBW). The risk of congenital malformations among children conceived via ART is contemplated to be high. The present case control study was conducted with an aim of analysing perinatal outcomes of children born by ART in the Indian context.

Methods

The case control study was conducted in the Army Hospital (Research and Referral), New Delhi. It included 82 cases and 164 controls. The data was collected on maternal and newborn characteristics among cases and controls. Perinatal outcomes were compared between ART conceived and spontaneously pregnant women in terms of birth weight, preterm, multiple pregnancies, and neonatal complications.

Results

Significant difference was observed in terms of the preterm delivery, birth weight, neonatal complications between the cases and the controls. The adjusted odds ratio (OR) was 21.6 (95% confidence interval [CI] 4.3, 112.9) for preterm delivery; 6.0 (95% CI 1.1, 43.8) for multiple pregnancy and 3.2 (95% CI 1.5, 7.0) for caesarean section. The risk of LBW and neonatal complications was heavily confounded by preterm delivery and multiple pregnancies, the adjusted OR being 0.9 and 1.0, respectively.

Conclusion

Increased risk of preterm delivery, multiple pregnancies and caesarean section was associated with ART. The LBW was confounded by preterm delivery and multiple pregnancies.Key Words: assisted reproductive techniques, odds ratio, perinatal outcomes     

体外受精胚胎移植助孕后双胎妊娠临床结果分析

目的：探讨试管婴儿双胎与自然妊娠双胎的妊娠、分娩的风险及新生儿结局。方法比较分析61例试管婴儿双胎与77例自然妊娠双胎母亲的一般情况、妊娠并发症、剖宫产情况及围产儿结局。结果试管婴儿组产妇平均年龄为(30．72±4．10)岁,与自然受孕组相比,差异有统计学意义(P<0．05)。试管婴儿组高龄初产产妇比例高于自然受孕组,试管婴儿组的产次显著低于自然受孕组,差异有统计学意义(P<0．05)。两组产检完成率、孕次及瘢痕子宫的差异无统计学意义(P>0．05)。试管婴儿组单绒毛膜性双胎发生率显著低于自然受孕组,差异有统计学意义(P<0．05),其他产科并发症差异无统计学意义(P>0．05)。试管婴儿组孕妇的剖宫产率高于自然受孕组,差异有统计学意义( P<0．05)。两组产后出血量、产后出血、输血率及子宫切除率差异无统计学意义(P>0．05)。试管婴儿组婴儿平均孕龄、活胎比例、低体质量儿与极低体质量比例、新生儿窒息率及胎儿性别方面与自然受孕组相比,差异无统计学意义(P>0．05)。结论与自然妊娠双胎相比,试管婴儿双胎妊娠并不增加孕妇的孕期及分娩的风险,且新生儿的出生结局亦无明显差异。     

体外受精-胚胎移植术后妊娠的系统管理及结局

目的　探讨体外受精 胚胎移植术 (IVF ET)后妊娠的系统管理方法及其对妊娠结局的影响。方法　回顾性分析在我院生殖医学中心行IVF ET、单精子卵胞浆内注射术 (ICSI)、冻融胚胎移植技术 (FET)的 374个妊娠周期的结局、围产儿情况及其管理方法。结果　 374个妊娠周期中 ,生化妊娠 19例 (5 .0 8% ) ,临床妊娠35 5例 (94 .92 % )。继续妊娠 85例。失访 11例 ,失访率为 3.10 %。流产 5 8例 ,流产率为 16 .34% ;宫外孕 11例 ,占 3.10 % ;宫内外同时妊娠 6例 ,占 1.6 9%。分娩 190例 ,其中多胎分娩 6 9例 ,占 36 .32 %。早产 6 5例 ,占34.2 1%。出生新生儿 2 5 9例 ,其中早产儿 10 9例 ,占 4 2 .0 8%。新生儿死亡 2例 ,占 0 .77%。死胎 4例 ,占1.5 2 %。新生儿畸形 3例 ,占 1.16 %。与在外院分娩者比较 ,于我院检查、分娩的妇女在流产、宫外孕、宫内外同时妊娠方面的差异无显著性 (P >0 .0 5 ) ;在多胎分娩、妊娠高血压综合征、低体重儿方面的差异有显著性 (P <0 .0 5 )。我院未发生孕产妇死亡、死胎及新生儿死亡。结论　建立完善的定期跟踪随访制度 ,加强围产保健 ,严密监护、积极治疗 ,可有利于保证IVF ET术后妊娠妇女的健康及改善围产儿的预后。     

妊娠合并先天性子宫畸形对母婴结局的影响

目的探讨先天性子宫畸形妊娠对于母婴结局的影响。方法回顾性分析2008年1月至2011年6月进入围生期的子宫畸形合并妊娠患者54例（畸形组）和同期正常子宫妊娠者60例（对照组）的临床资料,比较2组的母婴结局。结果畸形组胎位异常发生率（46.3%）、胎膜早破发生率（27.8%）、剖宫产率（77.8%）、早产率（25.9%）及足月低体重儿发生率（11.1%）均显著高于对照组;平均孕周（37.1周）、新生儿平均出生体重（2728g）显著低于对照组;而胎儿宫内窘迫、新生儿窒息发生率2组差异无统计学意义（11.1%vs 8.3%,7.4%vs6.7%）。结论子宫畸形合并妊娠可对母婴结局产生不良影响,应引起临床医生足够重视,加强育龄妇女孕前检查及孕期保健。     

重症监护病房新生儿死亡病例分析

目的探讨新生儿重症监护病房（NICU）新生儿死亡的危险因素及变迁。方法回顾性分析我院NICU 2004年1月—2009年12月期间死亡的129例患儿的病历资料,筛选死亡危险因素。结果体重〈1.5 kg新生儿年均病死率9.2%;胎龄≤32周早产儿年均病死率为9.4%;死亡新生儿中出生48 h内病死率达34.9%.2004年—2009年新生儿直接死亡原因排序依次为感染性疾病、窒息及其并发症、先天性畸形、其他疾病。结论胎龄小、出生体重低及母亲高龄始终是新生儿死亡的高危因素,死亡高危时段在出生后48 h内。感染性疾病、窒息及其并发症是最主要的直接死因,先天性畸形致死率增高,疾病谱有扩大趋势。