不同分娩方式对晚期早产儿呼吸系统疾病影响的回顾性研究

目的：探讨不同分娩方式对晚期早产儿呼吸系统疾病发生及预后的影响。方法以2010年1月至2014年12月，在瑞安市人民医院产科出生的晚期早产儿为研究对象，将选择性剖宫产（ ECS）的病例作为研究组，阴道分娩和急诊剖宫产的病例作为对照组。结果入选的ECS新生儿呼吸系统疾病发病率41．7％，急诊剖宫产新生儿发病率45．2％，两者无统计学差异（χ2＝0．415，P＞0．05）；阴道分娩新生儿发病率为19．8％，与ECS者差异有统计学意义（χ2＝34．380，P＜0．05）。34周组、35周组、36周组的晚期早产儿呼吸窘迫综合征（ RDS）及湿肺（ TTN）的发生率，ECS者比阴道分娩者更多，差异有统计学意义（χ2值分别为6．018、6．716、6．455、6．437、9．815、13．360，均P＜0．05）；34周组、35周组、36周组的晚期早产儿住院时间、NICU入住率和CPAP通气使用率，ECS者比阴道分娩者更多，差异有统计学意义（t值分别为2．627、2．139、2．191，χ2值分别为14．380、14．650、23．650、6．254、20．040、9．010，均P＜0．05）。结论 ECS和急诊剖宫产晚期早产儿呼吸系统疾病发病风险相当；相比阴道分娩，ECS会增加晚期早产儿呼吸系统疾病发生率及预后不良。

Retrospective study of influence of different delivery modes on respiratory system diseases in late preterm infants

Objective To study the influence of different delivery modes on the occurrence and prognosis of late preterm infant ’ s respiratory system disease.Methods Late preterm infants born in People’ s Hospital of Rui’ an from January 2010 to December 2014 were enrolled in study.Cases of elective cesarean section ( ECS) were included in study group, and the control group included cases of vaginal delivery and emergency cesarean section.Results The incidence of respiratory disease was 41.7% in the study group and 45.2% in the cases of emergency caesarean section.There was no significant difference between them (χ2 =0.415, P>0.05).The incidence was 19.8%in the cases of vaginal delivery, which was significantly different from the study group (χ2 =34.38,P<0.05).In terms of incidence of respiratory distress syndrome ( RDS) and transient tachypnea of newborn ( TTN) in late premature born at 34, 35 and 36 weeks, it was higher in ECS cases than in cases of vaginal delivery with significant differences (χ2 value was 6.018, 6.716, 6.455, 6.437, 9.815 and 13.36, respectively, all P<0.05).Compared to the cases of vaginal delivery, the study group was higher in prolonged hospital stays, admissions to neonatal intensive care unit ( NICU ) and continuous positive airway pressure ( CPAP ) usage, and the differences were significant (t value was 2.627, 2.139 and 2.191, respectively,χ2 value was 14.38, 14.65, 23.65, 6.254, 20.04 and 9.010, respectively, all P<0.05).Conclusion The risk of respiratory disease is equivalent between the late preterm infants delivered via ECS and emergency cesarean delivery.Compared to vaginal delivery, ECS may increase the incidence of respiratory disease and poor prognosis on late preterm infants.