早产相关因素及早产儿结局临床分析

目的探讨早产发生的高危因素及早产对围生儿的影响。方法选取2001年1月1日-2007年6月30日在我院分娩的早产儿508例作为病例组，并随机选取同期足月分娩产妇508例作为对照组，比较两组产妇的相关情况，围产儿结局，分析早产的高危因素。结果早产儿窒息、RDS发生率及死亡率与足月儿相比差异显著；孕周越小，发病率及死亡率越高。胎膜早破、胎位异常、胎盘因素是造成早产的高危因素。应用地塞米松与未应用者相比，足量应用地塞米松与未足量应用者相比，新生儿并发症发生率、早产儿死亡率均明显降低。孕35周后早产患者，延长孕周并不能降低早产儿并发症发生率及死亡率。结论早产的发生是多种因素的结果。孕周越小，早产儿发病率及死亡率越高。应用糖皮质激素是改善早产儿结局的重要治疗措施。35～36^＋6周PPROM者建议在破膜48h内分娩，以减少早产儿并发症。

Study on related factors of preterm delivery and outcomes of the premature infants

Objective To investigate the risk factors, perinatal management of preterm delivery and outcomes of premature infants. Methods The medical records of 508 preterm cases admited in our hospital from January. 2001 to June. 2007 were reviewed as study group and 508 term delivery as control group. The risk factors of preterm labor, complications and outcomes of premature infants were compared. Results The incidences of neonatal asphyxia and RDS in study group were significantly higher than control group. The less the gestational age, the higher mortality and morbidity of neonate. Premature rupture of fetal membranes （PROM）, abnormal fetal position and placenta factors were the major causes of preterm delivery. The incidence of neonatal complications, mortality were higher in patients with no or insufficient Dexamethasone treatment. Extension of gestctimal age after 35 weeks could not reduce incidence of neonatal compications or mortality. Condnsions Preterm delivery is a disease resulted from mutiple causes. The less the gestational age, the higher morbidity and the mortality of neonate. Dexamethasone presents benefit effects on pregnancy outcomes and premature infants. It is recommended that the patients with PROM at 35-36^＋6 weeks＇gestation should give birth within 48 h of rupture to reduce the neonatal complications.