小于胎龄儿健康状况及其影响因素的流行病学调查

【目的】 分析小于胎龄儿(small-for-gestational-age infants,SGA)的出生、健康状况、并发症发生、死亡及其影响因素,以期为产科、儿科、儿保等科学护理SGA提供临床依据。 【方法】 回顾性分析2006年1月1日-2007年12月31日在北京市海淀区妇幼保健院出生的全部新生儿资料,选择其中的217例SGA为病例组,每月1日出生的240例适于胎龄儿儿(appropriate gestational age infants,AGA)为对照组。详细分析两组并发症发生情况及母亲孕期感染、妊高症、糖尿病、贫血、胎膜早破、羊水异常、脐带异常、双胎等情况。 【结果】 2006-2007年北京市海淀区妇幼保健院共分娩新生儿22 752名,其中SGA儿217例,SGA出生率为0.95%;SGA并发症发生率依次为高胆红素血症(31.3%)、呼吸系统并发症(10.6%)、贫血(5.5%)、低血糖(5.1%)、消化系统并发症(4.6%),SGA并发症发生率高于AGA,差异有统计学意义(P＜0.05);母亲妊高症、脐带异常、胎膜早破、双胎妊娠是导致SGA的主要因素;小于胎龄儿死亡率为1.4%,明显高于AGA死亡率(0.14%)及新生儿总死亡率(0.15%),差异有统计学意义(P＜0.05)。 【结论】 SGA发生与母亲妊高症等因素有关,SGA容易发生并发症,死亡率高,应该加强预防和科学护理。

Epidemiological study on health and influencing factors of the small for gestational age infants

【Objective】To study the birth rate,health,complications,mortality of small for gestational age(SGA) infants and influencing factors,so as to provide evidence for caring SGA infants in the department of obstetrics,pediatrics and child healthcare.【Methods】Data of all newborns born in Beijing Haidian Maternal and Child Health Hospital were collected for statistical analyses from January 1,2006 to December 31,2007.The 217 SGA infants were selected as the case group.The appropriate for gestational age(AGA) infants who were born on the first day of every month were randomly selected as the comparison group.The complications and maternal infections,pregnancy-induced hypertension,diabetes,anemia,premature placenta,etc.were analyzed.【Results】In the 22 752 infants born from 2006 to 2007,217 infants were SGA.The birth rate of SGA infants was 0.95%.The incidence rate of complications of SGA infants from high to low were:hyperbilirubinemia(31.3%),respiratory diseases(10.6%),anemia(5.5%),hypoglycemia(5.1%),digestive diseases(4.6%).The SGA infants had significantly higher incidence rate of complications than those AGA infants(P<0.05).Pregnancy-induced hypertension,abnormality of umbilical cord,premature rupture of membranes and twin were the major factors associated with SGA.The mortality of SGA was 1.4%,higher than that of AGA(0.14%) and total newborn mortality(0.15%),with statistically significant difference(P<0.05).【Conclusion】The factors such as pregnancy-induced hypertension was the major factor associated with SGA.SGA had higher incidence rate of complications and mortality,who should be paid attention in further prevention and scientific care.