共查询到19条相似文献,搜索用时 218 毫秒
1.
约3%的孕妇患有慢性肾脏病(chronic kidney disease,CKD)。该文复习了关于CKD母亲(包括透析和肾移植患者)的新生儿结局的文献。文献显示:妊娠合并CKD会增加新生儿发生早产、低出生体重及小于胎龄儿的风险,但不增加发生先天结构畸形的风险;从远期结局来看,对子代体格发育、免疫功能无显著影响;子代的神经发育结局与早产、低出生体重相关,与宫内药物暴露无关。仍需更进一步的研究及随访以探讨CKD母亲的新生儿结局。 相似文献
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目的 探讨孕前双亲体重指数(BMI)和母孕期体重增值及其交互作用对新生儿出生体重的影响。方法 选取2017年1月至2018年10月在西安交通大学第一附属医院做定期产检并足月单胎分娩的孕妇1 127例,收集其孕前BMI、孕期体重增值、孕前丈夫BMI、新生儿出生体重等信息,分析新生儿出生体重与孕前父母BMI和母亲孕期体重增值之间的相关性及两变量间的交互作用。结果 1 127例足月新生儿中,低出生体重检出25例(2.22%),巨大儿检出43例(3.82%)。低出生体重儿、正常体重儿、巨大儿三组双亲孕前BMI值、母亲孕期体重增值的比较差异均有统计学意义(P < 0.05)。新生儿出生体重与孕前双亲BMI值、母亲孕期体重增值呈低度正相关(r=0.097~0.322,P < 0.05);母亲孕前低体重可增加低出生体重儿的发生风险(RR=4.17,95% CI:1.86~9.38);母亲孕前超重/肥胖、孕期体重增值超标可增加巨大儿的发生风险(分别RR=3.59,95% CI:1.93~6.67;RR=3.21,95% CI:1.39~7.37)。未发现母亲孕前BMI与孕期体重增值对新生儿出生体重的交互作用。结论 孕前双亲BMI和母亲孕期体重增值与新生儿出生体重有关,而母亲孕前BMI和孕期体重增值之间无交互作用。 相似文献
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背景:高尿酸血症(HUA)患病率逐年增高,不仅与痛风、尿酸盐肾病和肾结石有关,还与内分泌代谢、心脑血管等系统疾病的发生和发展有关。
目的:探讨孕母妊娠晚期血尿酸水平与不良妊娠结局、新生儿尿酸水平及新生儿合并症的关系。
设计:回顾性巢式病例对照研究。
方法:以2020年1~12月在北京大学人民医院产检的孕母为队列人群,根据孕母妊娠晚期血尿酸水平分为HUA组和非HUA组,比较两组妊娠结局和新生儿临床结局。根据孕母妊娠晚期血尿酸水平(μmol·L-1)分为低浓度(<360)、中浓度(~420)和高浓度(>420),采用线性回归和Logistic 回归模型分析孕母血尿酸水平与早产、低出生体重、小于胎龄儿的关系。孕母妊娠晚期尿酸值及新生儿生后24 h尿酸值相关性分析采用Spearman秩相关分析。
主要结局指标:孕母血尿酸水平与早产、低出生体重和小于胎龄儿的关系。
结果:共纳入孕母2 397例(新生儿2 581例),HUA组216例(9.0%),非HUA组2 181例。HUA组孕母所生新生儿出生体重低于非HUA组(2 925 g vs 3 260 g,P<0.001),差异均有统计学意义;而早产(18.5% vs 8.9%)、低出生体重(23.1% vs 7.1%)、小于胎龄儿(29.2% vs 10.6%)和转儿科比例(19.9% vs 11.1%)均高于非HUA组,差异均有统计学意义(P<0.001)。尿酸水平高浓度组孕母分娩的新生儿出生体重较低浓度组低54.0 g(95%CI:-106.5~-1.6,P=0.043),发生早产的风险增加74%(OR=1.74,95%CI:1.08~2.8,P=0.023),发生小于胎龄儿的风险增加85%(OR=1.85,95%CI:1.26~2.73,P=0.002)。新生儿生后24 h内尿酸水平与孕母妊娠晚期尿酸水平呈中等相关(r=0.613,P=0.000)。两组早产儿合并症差异无统计学意义。
结论:母体妊娠晚期HUA与早产、低出生体重、小于胎龄儿的发生相关。 相似文献
4.
目的 比较辅助生殖技术(ART)双胎妊娠与自然受孕(SC)双胎妊娠对新生儿结局的影响。方法 回顾性纳入南京市妇幼保健院2017~2019年期间分娩的胎龄≥ 24周活产双胎儿3 356例,其中ART组双胎儿2 006例(1 003对),SC组双胎儿1 350例(675对),收集母亲一般资料、妊娠期合并症及新生儿一般资料、新生儿疾病及结局,进行两组间比较。结果 ART组母亲平均年龄大于SC组(P < 0.05),初产率、剖宫产率及宫颈环扎手术率高于SC组(P < 0.05)。ART组母亲妊娠相关合并症,如高血压、糖尿病及产后出血发生率均高于SC组(P < 0.05)。ART组新生儿平均胎龄低于SC组(P < 0.05),极低出生体重儿比例高于SC组(6.8% vs 5.8%,P < 0.05),但ART未增加早产及低Apgar评分的风险。两组新生儿的病死率及新生儿疾病,如呼吸窘迫综合征、Ⅱ/Ⅲ期坏死性小肠结肠炎、支气管肺发育不良、Ⅲ~Ⅳ级颅内出血的发生率差异均无统计学意义(P > 0.05)。结论 与SC双胎妊娠相比,ART双胎妊娠未明显增加新生儿病死率及不良结局。 相似文献
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吴素英 彭芬 丁婷 谭红燕 吴倩 于新桥 盘志平 谢红玲 夏宏 费宝敏 柳开典 袁作芬 谭从容 蒋浪 张松华 易琼 吴卫华 罗琳琳 沈昌桃 张金帆 黄振菊 夏世文 《中国当代儿科杂志》2019,21(1):6-10
目的 了解湖北恩施土家族苗族自治州新生儿窒息的发生率及重度窒息发生的影响因素。方法 选择湖北恩施土家族苗族自治州16家医院作为研究现场。收集2016年1~12月在该16家医院出生的活产婴儿22294例的临床资料进行回顾性分析,调查新生儿窒息的发生率及重度窒息发生的影响因素。结果 22294例活产新生儿中,733例(3.29%)诊断为新生儿窒息,其中轻度窒息627例,重度窒息106例。单因素分析显示,母亲文化程度低、孕期贫血、绒毛膜羊膜炎、羊水异常、脐带异常、前置胎盘、胎盘早剥以及民族为土家族的新生儿或早产出生、低出生体重者重度窒息发生率较高(P < 0.05)。结论 湖北恩施土家族苗族自治州新生儿窒息发生率较高。母亲文化程度低、孕期贫血、绒毛膜羊膜炎、脐带异常、羊水异常、前置胎盘、胎盘早剥及民族为土家族、早产出生、低出生体重可能与新生儿重度窒息的发生有关。 相似文献
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新生儿临床风险指数( clinical risk index for babies,CRIB )是一种应用于早产低出生体重儿评估最初疾病严重程度,预测死亡风险率,评估各医疗机构的自身医疗质量,以及对各医疗机构之间进行客观医疗水平比较的评分系统,对我国日益发展的新生儿医学起着重要的作用。本文详细介绍了CRIB评分系统的来源及发展现状、具体评分细则以及CRIB的优点,对早产低出生体重儿死亡风险预测的准确性,并分析了其应用于预测早产低出生体重儿远期神经系统发育的价值。 相似文献
7.
正常妊娠与妊高症对新生儿影响的对照分析 总被引:1,自引:1,他引:1
应用回顾性对照分析的方法,对127例重度、154例中度妊高症母亲与281例正常母亲及其新生儿进行分析,结果足月儿平均出生体重在重度妊高症母亲组中为3229克,低于正常母亲组的3372克(P<0.05)。低体重儿在重度妊高症母亲组中发生率为13.5%,高于正常母亲组1.13%(P<0.005)。自发性早产发生率在重度妊高症母亲组为30.77%,明显高于中度组与正常组的7.8%和4.05%(P分别<0.005与0.001)。平均胎盘重量在重度妊高症组为584克,与正常组比较有显著差别(P<0.05)。新生儿发病率在重度妊高症母亲组中为42.85%,与正常组的新生儿13.31%比较有显著差别(P<0.001)。认为围生医学的各种防治措施降低了妊高症与子痫的发生,但新生儿的出生体重、低出生体重与早产的发生,以及疾病发生率并未明显改善。 相似文献
8.
新生儿由于早产或胎儿生长受限而造成的低出生体重将会对肾脏的发育产生不良影响。在成人期,低出生体重儿的远期不良效应与多种肾脏疾病进展相关。研究提示低出生体重可能通过影响肾单位的发育、微血管结构功能及内分泌水平而参与了多种肾脏疾病的发生和发展。该文主要就低出生体重与肾脏疾病发生的关系做一综述。 相似文献
9.
新生儿的出生体重是衡量胎儿宫内营养状况及出生结局的一项重要指标。目前我国每年仍有超过100万的低出生体重儿,同时巨大儿的出生率逐年上升。大量出生体重的相关研究发现过低或过高的出生体重不仅与出生后较差的体格生长和神经发育落后风险相关,同时也增加成年期代谢病及心血管疾病的风险,由此,重新认识了出生体重及其对一生健康与发展的重要性。文章通过对不同出生体重的流行病学特点、出生体重相关的影响因素,其对神经认知发育、代谢与心血管疾病的影响及其机制的最新研究进展进行介绍,提出正确认识出生体重,早期防控不适当出生体重的相关风险因素,权衡利弊,把控
出生后追赶的速率和程度,可能有利于一生的健康与发展。 相似文献
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11.
目的探讨妊娠期合并糖代谢异常对子代新生儿期胰岛素敏感性的影响。方法选择2009年12月至2010年11月本院产科出生的新生儿,根据母亲妊娠期是否合并糖代谢异常分为糖代谢异常母亲的新生儿和糖代谢正常母亲的新生儿。所有研究对象均进行出生体格测量,并于生后 3 天内测定空腹血糖( FPG) 和空腹血清胰岛素( FINS) ,计算胰岛素敏感指数( ISI) ,采用胰岛素稳态模型( HOMA) 计算胰岛素抵抗指数( IR) ,即 HOMA-IR,其中 FINS、ISI 和 HOMA-IR 值为胰岛素敏感性的评价指标。以性别、胎龄、出生体重为协变量,分别在早产儿和足月儿中进行胰岛素敏感性的协方差分析。结果 89 例早产新生儿和 96 例足月新生儿纳入分析。糖代谢异常母亲新生儿的出生体重、出生身长和重量指数( PI) 与糖代谢正常母亲的新生儿相比,差异无统计学意义( P >0. 05) 。与糖代谢正常母亲的早产儿相比,糖代谢异常母亲的早产儿 FPG 降低、FINS 升高,差异有统计学意义[FPG( mmol/L) : ( 4. 00 ±0. 25) 比( 4. 82 ±0. 18) ,FINS( 经对数 Lg 转换) : ( 0. 69± 0. 06) 比( 0. 54 ± 0. 04) ,P < 0. 05],ISI 值降低、HOMA-IR 值升高,但差异无统计学意义[ISI( 经对数 Ln 转换) : ( -2. 89 ±0. 15) 比( -2. 78 ±0. 11) ,HOMA-IR 值( 经对数 Lg 转换) : ( -0. 10 ±0. 06)比( -0. 15 ±0. 05) ,P >0. 05]; 足月儿中糖代谢异常母亲的新生儿 FPG、FINS 和 HOMA-IR 值低,ISI 值高,但差异均无统计学意义[FPG( mmol / L) : ( 4. 68 ± 0. 23) 比( 5. 17 ± 0. 13) ,FINS( 经对数 Lg转换) : ( 0. 56 ±0. 06) 比( 0. 61 ±0. 03) ,HOMA-IR 值( 经对数 Lg 转换) : ( -0. 14 ±0. 06) 比( -0. 03± 0. 03) ,ISI( 经对数 Ln 转换) : ( - 2. 79 ± 0. 14) 比( - 3. 04 ± 0. 08) ,P > 0. 05]。结论母亲妊娠期合并糖代谢异常虽然对新生儿的出生体重没有影响,但血糖仍然呈现低水平趋势,且对早产儿胰岛素敏感性可能有一定的影响。 相似文献
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Edstedt Bonamy AK Bengtsson J Nagy Z De Keyzer H Norman M 《Acta paediatrica (Oslo, Norway : 1992)》2008,97(8):1080-1085
AIM: Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm. METHODS: Eighty-six healthy 15-year-old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight < 1500 g) and 41 controls born at term. Using a pulse-gated Fiesta sequence on a 1.5T MR-scanner, 25 images were collected within the heart cycle at several levels of the descending aorta. End-diastolic cross-sectional areas were semi-automatically calculated using an active contour model. RESULTS: Subjects born preterm had narrower aortic lumen. The difference was 16% in the thoracic and 19% in the abdominal aorta after adjustment for body surface area and gender (p < 0.001). Maternal smoking in pregnancy was also found to be an independent risk factor for aortic narrowing in the offspring (difference 10%-13% throughout the aorta vs. offspring to nonsmoking mothers). Adolescents born preterm had higher systolic and diastolic blood pressures; however, blood pressures did not correlate with aortic size or maternal smoking during pregnancy. CONCLUSION: Very preterm birth and exposure to maternal smoking in foetal life are independent and strong risk factors for general aortic narrowing 15 years after birth. 相似文献
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Ferenc Bánhidy Nándor Ács Erzsébet H. Puhó Andrew E. Czeizel 《Congenital anomalies》2010,50(2):122-128
Pholedrine was a frequently used drug for the treatment of severe hypotension in some countries, including Hungary. The possible teratogenic effect of pholedrine was not checked; therefore; the birth outcomes, particularly congenital abnormalities (CAs), of infants born to women treated with pholedrine during pregnancy, and pregnancy complications were evaluated in the population‐based large dataset of the Hungarian Case‐Control Surveillance System of Congenital Abnormalities. Cases with CA and their matched controls without CA born to mothers with pholedrine use during pregnancy were compared. Of 22 843 cases and 38 151 controls, 768 (3.4%) and 1509 (4.0%) were born to mothers with pholedrine treatment, respectively (adjusted odds ratios [OR] with 95% CI: 0.9, 0.8–1.0). There was no higher risk for any CA group in the offspring of mothers who used pholedrine during the second and/or third month of pregnancy (i.e. the critical period of most major CA). The mean gestational week at delivery and birthweight was similar in newborns of women with or without pholedrine treatment during pregnancy. The pattern of pregnancy complications was characteristic (lower incidence of preeclampsia/eclampsia, while higher incidence of severe nausea/vomiting and anemia), explained mainly by the underlying maternal hypotension. In conclusion, pholedrine treatment in pregnant women was not associated with a higher risk for CA or other adverse birth outcomes, such as preterm birth or low birthweight. The knowledge of the teratogenic potential of pholedrine may contribute to the evaluation of other sympathomimetic drugs. 相似文献
14.
MOS HIP: McMaster outcome study of hypertension in pregnancy. 总被引:2,自引:0,他引:2
BACKGROUND: The offspring of women with hypertension during pregnancy are at increased risk of low birthweight, preterm birth, diseases of prematurity and death. The risk of developing these outcomes among women with either preeclampsia or chronic hypertension, relative to those with gestational hypertension, is not known. STUDY DESIGN: Prospective cohort study. PARTICIPANTS: A total of 1948 singleton women seen at a large tertiary care obstetrical center, whose blood pressure was greater than 140/90 mm Hg during pregnancy. The four types of hypertension were strictly defined: 864 women (44.4%) had gestational hypertension, 459 (23.6%) isolated chronic hypertension, 501 (25.7%) isolated preeclampsia, and 124 (6.4%) chronic hypertension with superimposed preeclampsia. OUTCOME MEASURES: The primary outcome of the study was a composite of the diseases of prematurity, need for assisted ventilation for greater than 1 day, or perinatal death. The secondary outcomes were each of those included in the primary endpoint, as well as admission to the neonatal ICU, small for gestational age (SGA) birthweight and preterm birth. We controlled for the effects of other maternal risk factors, such as age, parity, history of preterm delivery, cigarette smoking, pre-pregnancy weight, diabetes mellitus (DM), renal dysfunction, and current use of an antihypertensive agent or prednisone. RESULTS: For the primary composite outcome, compared to the offspring of women with gestational hypertension, the adjusted odds ratio was 1.9 (95% confidence interval 1.2 to 3.0) in the preeclamptic group and 2.0 (95% confidence interval 1.0 to 4.0) for those with chronic hypertension plus superimposed preeclampsia. Those with preeclampsia were at increased risk for small for gestational age birthweight (odds ratio 2.2, 95% confidence interval 1.5 to 3.1), as were the offspring of mothers who had chronic hypertension with superimposed preeclampsia (odds ratio 2.1, 95% confidence interval 1.2 to 3.8). Similarly, the rate of preterm birth before 32 weeks was highest among the infants of both preeclamptic mothers (28.5%; odds ratio 4.7, 95% confidence interval 2.9 to 7.6) and those with chronic hypertension and preeclampsia (30.5%; odds ratio 3.5, 95% confidence interval 1.8 to 6.7). The perinatal mortality rate was highest in the group of women with chronic hypertension plus preeclampsia (9.2%; odds ratio 3.2, 95% confidence interval 1.2 to 9.1). Other significant risk factors for the primary composite outcome included previous preterm delivery (odds ratio 2.7, 95% confidence interval 1.4 to 5.2), smoking (odds ratio 1.8, 95% confidence interval 1.1 to 3.0) and use of an antihypertensive agent during pregnancy (odds ratio 1.8, 95% confidence interval 1.2 to 2.7). Prednisone use was strongly associated with risk for perinatal death (odds ratio 4.9, 95% confidence interval 1.4 to 17.1). CONCLUSIONS: Relative to women with isolated gestational hypertension, those who develop preeclampsia, either with or without underlying chronic hypertension, experience worse perinatal outcomes. A history of previous preterm delivery and maternal smoking increase the rate preterm birth and major perinatal disease. Antihypertensive and prednisone therapy may be important risk factors for adverse perinatal events, but further research is needed to confirm these findings. 相似文献
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目的探讨妊娠期抑郁症与新生儿低出生体重的关系,为预防新生儿低出生体重提供科学依据。方法系统收集研究妊娠期抑郁症与低出生体重关系的队列研究文献,进行Meta分析,由两名研究人员独立地提取数据,按照NOS量表对纳入文献进行质量评价,采用Egger's检验评估发表偏倚。结果共纳入12篇队列研究文献,涉及37 192个样本。Meta分析结果表明:妊娠期抑郁症与新生儿低出生体重有关(Z=2.08,P=0.038),妊娠期抑郁的孕母其新生儿发生低出生体重的风险更高(RR=1.303,95%CI:1.015~1.672)。敏感性分析结果表明该Meta分析结果稳定可靠,Egger's检验结果表明无发表偏倚。结论妊娠期抑郁症可能是新生儿低出生体重的危险因素。 相似文献
16.
Källén B 《Archives of pediatrics & adolescent medicine》2004,158(4):312-316
BACKGROUND: Exposure to antidepressants during the third trimester of pregnancy has been associated with an increased risk for adverse birth outcomes, including preterm birth, respiratory distress, and hypoglycemia. OBJECTIVE: To investigate neonatal outcomes in 997 infants (987 mothers) after maternal use of antidepressants based on prospectively recorded information in antenatal care documents. RESULTS: An increased risk for preterm birth (odds ratio [OR], 1.96) and low birth weight (OR, 1.98) was verified, but the gestational week-specific birth weight was increased notably after exposure to tricyclic antidepressants. An increased risk for a low Apgar score (OR, 2.33), respiratory distress (OR, 2.21), neonatal convulsions (OR,1.90), and hypoglycemia (OR, 1.62) was found, the latter especially after exposure to tricyclic drugs, but no significant effect on the frequency of neonatal jaundice was seen (OR, 1.13). Most effects seemed not to be selective serotonin reuptake inhibitor drug specific, and outcomes after exposure to paroxetine hydrochloride were not worse than after exposure to other selective serotonin reuptake inhibitors. CONCLUSIONS: Neonatal effects after maternal use of antidepressant drugs during late pregnancy were seen. Selective serotonin reuptake inhibitors may be the drugs of choice during pregnancy. 相似文献
17.
Perinatal outcome in an obstetric cohort of Mozambican women 总被引:4,自引:0,他引:4
A prospective cohort of 908 consecutively enrolled pregnant women with biparietal diameter (DBP) compatible with gestational age equal to or below 21 weeks were followed up regularly at 2-4 weeks intervals. Normal antenatal care routine was applied. The newborns were followed until 7 days postpartum. The setting was two suburban antenatal clinics in Maputo and the delivery ward at the Maputo Central Hospital. The main outcome variables were low birth weight (LBW), preterm delivery, intrauterine fetal death, perinatal death and small for gestational age (SGA). For each of these variables the odds ratio for maternal risk factors was estimated with 95 per cent confidence interval and multiple logistic regression analysis was used. LBW occurred in 16.2 per cent and low maternal weight, low weight gain during pregnancy and not having a living child were risk factors. Prevalence of preterm birth was 15.4 per cent and low weight gain during pregnancy and malaria in the perinatal period were risk factors. Four per cent of mothers delivered stillborns and syphilis serology (positive VDRL test) was a risk factor. Perinatal death occurred in 4.7 per cent. These deaths were associated with being SGA, LBW or preterm at birth. Of the cohort women, 9.7 per cent delivered SGA newborns. It was concluded that maternal constitutional factors, particularly maternal weight gain, maternal height and maternal weight as well as syphilis and malaria during pregnancy, need to be given attention concerning the adverse outcomes addressed. The establishment of an obstetric cohort, followed prospectively, was possible in a low-income setting with limited numbers lost to follow-up at delivery. 相似文献
18.
AIM: To explore risk factors that are associated with preterm birth and full-term small-for-gestational-age (SGA) birth for a Pacific population. METHODS: Data were gathered from the Pacific Islands Families Study. Mothers of a cohort of 1398 Pacific infants born in South Auckland, New Zealand during 2000 were interviewed when their infants were 6 weeks old. Mothers were questioned regarding maternal health, antenatal care and life-style behaviours. Data regarding birth outcomes were obtained from hospital records. Analyses focused on 1324 biological mothers who gave birth to a singleton and had valid data for birth outcomes. RESULTS: Of 1324 singleton infants, the mean birthweight was 3.60 kg with standard deviation of 0.60 kg. Fifty-two (3.9%) had birthweight less than 2500 g. Ninety-four (7.1%) were born at less than 37 weeks of gestation. Most socio-demographic factors were not associated with poor birth outcomes. Primiparous birth, less frequent attendance of antenatal care and mother's history of high blood pressure were associated with preterm birth and SGA. Smoking during pregnancy increased the odds of having an SGA but not preterm birth. On the other hand, unplanned/unsure pregnancy and prior early pregnancy loss were associated with preterm birth but not SGA. CONCLUSION: Corroborating research conducted with other populations, most of the internationally and nationally recognised risk factors for preterm birth and SGA are also important for Pacific people. Smoking seems to explain more poor birth outcomes in Pacific Islands than in the New Zealand population as a whole. 相似文献
19.
Objective To evaluate the prevalence of thrombocytopenia in neonates born to mothers with pregnancy induced hypertension (PIH) and identify
the associated material and neonatal characteristics.
Methods In the current, prospective study, platelet counts were assessed serially. Maternal and neonatal characteristic were recorded
in pre-designed proforma. Primary outcome measures were thrombocytopenia defined as platelet count of <150000/mm3 and severe thrombocytopenia if counts were <30000/mm3 or <50000/mm3 with bleeding.
Results Of 97 neonates born to PIH mothers 35 (36.1%) had thrombocytopenia. In 20 (20.6%) thrombocytopenia was severe. Higher percentage
of thrombocytopenia was associated with male gender (47.7%), low birth weight (71.4%) and prematurity (67.4%). Severe thrombocytopenia
was significantly associated with low birth weight (OR: 4.58; 95% CI: 0.98–21.3; p<0.03) and prematurity (OR: 2.52; 95% CI:
0.87–7.24; p<0.05). Material parity, onset of PIH, and medications did not seem to be associated significantly.
Conclusion Premature and low birth weight neonates born to mothers with pregnancy induced hypertension would require scrutiny for thrombocytopenia
during early neonatal period. 相似文献