宫内感染对新生儿呼吸窘迫综合征影响研究

目的探讨宫内感染对新生儿呼吸窘迫综合征(NRDS)的影响。方法回顾性分析2010年3月至2014年2月南京军区福州总医院产科出生并在新生儿病房住院的462例早产儿的临床资料,采用Logistic回归分析宫内感染对早产儿NRDS发病率的影响因素。结果影响早产儿NRDS发病的因素包括胎龄、出生体质量、Apgar评分、胎膜早破、羊水情况、新生儿败血症,其中,胎膜早破、羊水污染及新生儿败血症会促进早产儿NRDS发病。胎膜早破的早产儿NRDS的发病率(34.3%,46/134)高于无胎膜早破者(24.1%,79/328),差异有统计学意义(χ~2=5.058,P<0.05)。无羊水污染的早产儿NRDS的发病率(22.3%,42/188),与Ⅰ度羊水污染者(24.6%,33/134)比较,差异无统计学意义(χ~2=0.229,P>0.05);低于Ⅱ度羊水污染者(34.4%,32/93),差异有统计学意义(χ~2=4.671,P<0.05);低于Ⅲ度羊水污染者(38.3%,18/47),差异有统计学意义(χ~2=5.036,P<0.05)。有新生儿败血症的早产儿NRDS的发病率(38.3%,36/94)高于无新生儿败血症者(24.2%,89/368),差异有统计学意义(χ~2=7.557,P<0.05)。结论宫内感染会增加早产儿NRDS的发病率。

Impact of intrauterine infection on neonatal respiratory distress syndrome

Objective To investigate the impact of intrauterine infection on neonatal respiratory distress syndrome (NRDS).Methods A retrospective study was performed on 462 cases of premature infants from March 2010 to February 2014.Logistic regres sion analysis was used to analyze the impact of intrauterine infection on the incidence of neonatal respiratory distress syndrome of premature infants.Results The results of the multi-factor regression analysis indicate that the factors impacting the incidence of NRDS of premature infants included gestational age,birth weight,Apgar score,premature rupture of membranes,amniotic fluid and neonatal septicemia,of which the factors related to intrauterine infection,including premature rupture of membranes,meconium-stained amniotic fluid and neonatal septicemia,were contributors to the occurrence of NRDS.With the NRDS incidence of premature infants with premature rupture of membranes at 34.33％ (46/134)which was higher than that of premature infants without premature rupture of membranes at 24.1％ (79/328),there was a significant difference between the two groups (x2 =5.058,P ＜ 0.05).As for meconiumstained amniotic fluid,the NRDS incidence of newborns without meconium-stained amniotic fluid was 22.3％ (42/188),compared with the NRDS incidences of premature infants with degree-Ⅰ(24.6％,33/134),the difference had no statistical significance (x2 =0.229,P ＞ 0.05);compared with the NRDS incidences of premature infants with degree-Ⅱ (34.4％,32/93),the difference had statistical sig nificance(x2 =4.671,P ＜ 0.05);compared with the NRDS incidences of premature infants with degree-Ⅲ (38.3％,18/47),the difference had statistical sigmficance (x2 =5.036,P ＜ 0.05).With the NRDS incidence of premature infants with septicemia at 38.30％ (36/94)which was higher than that of premature infants without septicemia at 24.2％ (89/368),there was a statistically significant difference between the two groups (x2 =7.557,P ＜ 0.05).Conclusion Intrauterine infection may increase the incidence of NRDS of premature infants.