妊娠期开展“孕妇学校”课程对新生儿结局影响的研究

目的:分析妊娠期开展“孕妇学校”课程对于新生儿结局的影响。方法:回顾性分析2018年10月—2019年8月在中国人民武装警察部队特色医学中心（我院）产科住院的单胎孕足月且妊娠期规律产检的孕妇资料,根据其妊娠期参加“孕妇学校”课程次数分为观察组高组（≥7次课程）、中组（4~6次课程）、低组（≤3次课程）及对照组（未参加课程）,各组分别有53例、56例、48例和69例孕妇纳入研究。观察各组新生儿结局指标,包括新生儿体质量、脐动脉血pH值、脐动脉血乳酸水平、出生后Apgar评分、胎粪吸入综合征（meconium aspiration syndrome,MAS）发生率、缺血缺氧性脑病（hypoxic ischemic encephalopathy,HIE）发生率、坏死性小肠炎（necrotizing enteritis,NEC）发生率及转入新生儿科率。结果:观察组高、中、低组在新生儿体质量、新生儿脐动脉血乳酸水平方面均低于对照组,差异均有统计学意义（P<0.05）;观察组高、中组在新生儿脐动脉血pH值、出生后1 min Apgar评分方面均高于对照组,差异有统计学意义（P<0.05）。观察组高、中、低组在新生儿出生后5 min Apgar评分、出生后10 min Apgar评分、新生儿发生MAS、HIE、NEC率及转入新生儿科率方面与对照组差异无统计学意义（P>0.05）。结论:妊娠期开展“孕妇学校”课程在一定程度上可以改善新生儿体质量、脐动脉血pH值、脐动脉乳酸水平及出生后1 min Apgar评分,值得孕期广泛开展。

The Study of Effect of"Pregnant Women School"Courses on Neonatal Outcomes During Pregnancy

Objective:To analyze the effect of"pregnant women school"courses during pregnancy on the neonatal outcomes.Methods:Patients who were hospitalized in the Obstetrics Department of Characteristic Medicine Center of the Chinese People′s Armed Police Forces from October 2018 to August 2019 with full-term single pregnancy and regular prenatal examination during pregnancy were retrospectively analyzed,including the observation-high group(53 women who participated in more than 7 courses),observation-middle group(56 women who participated in from 4 to 6 courses),observation-low group(48 women who participated in less than 3 courses),and the control group(69 women who did not participated in any course).The neonatal outcomes including neonatal weight,umbilical artery blood pH,umbilical artery lactate level,postnatal Apgar scores,meconium aspiration syndrome(MAS)rates,hypoxic ischemic encephalopathy(HIE)rates,necrotizing enteritis(NEC)rates and rates of transfer to neonatal department were compared.Results:The high,middle and low groups in the observation groups were lower than the control group in neonatal weight and neonatal umbilical artery blood lactic acid level,the difference was statistically significant(P<0.05).The pH of umbilical artery blood and Apgar score of 1 min after birth in high and middle groups in the observation groups were higher than those of control group,the difference was statistically significant(P<0.05).There was no significant difference in Apgar score at 5 min after birth,Apgar score at 10 min after birth,MAS,HIE,NEC rate and neonatal transfer rate among the four groups(P>0.05).Conclusions:The courses of"pregnant women school"during pregnancy can improve neonatal outcomes including neonatal weight,umbilical artery blood pH,umbilical artery lactate level,and Apgar score of 1 min after birth,and therefore,it is worth carrying out extensively during pregnancy.