新生儿眼底出血的危险因素分析

目的探讨新生儿眼底出血(retinal hemorrhage,RH)的相关危险因素。方法选择2014年3月至2015年2月于成都市妇女儿童中心医院新生儿科应用RetcamⅢ视网膜眼底成像系统完成眼底检查的1 643例住院患儿,首次检查时间为其出生后1周内。收集受检患儿及其母亲的相关资料,对产妇年龄、妊娠期合并症(妊娠期高血压疾病、妊娠期糖尿病、胆汁淤积症、血小板减少症)、患儿胎龄、多胎、生产方式、新生儿窒息、头颅血肿等因素进行单因素方差分析,对P0.05的临床因素行多因素Logistic回归分析。结果 1 643例新生儿中发生RH者251例,Ⅰ~Ⅱ级出血159例,Ⅲ~Ⅳ级出血92例。多因素回归分析提示产妇血小板减少症、顺产、新生儿窒息为RH的危险因素,同时产妇血小板减少症、新生儿窒息与严重RH的发生相关(P0.05),但窒息程度与RH程度无明确相关性(P0.05)。结论产妇血小板减少症为新生儿RH的危险因素且与严重RH发生相关。顺产、窒息亦为新生儿RH的危险因素。

Risk factors of retinal hemorrhage in newborns

Objective To explore the risk factors of retinal hemorrhage ( RH ) of newborns .Methods 1 643 infants hospitalized in Chengdu Women’s and Children’s Central Hospital were enrolled in this study from March 2014 to February 2015.Eye examinations with RetCamⅢwere performed within 1 week of birth .Related information of newborns and their mothers were collected . One-way ANOVA was taken to analyze the factors , including maternal age , pregnancy complications ( gestational hypertension , gestational diabetes, pregnancy cholestasis, thrombocytopenia), gestational age, multifetation, mode of delivery, suffocation, cranial hematoma, and then the clinical factors (P<0.05) were analyzed by multivariate logistic regression analysis .Results RH was found in 251 infants out of 1 643 cases.159 infants were Ⅰ~Ⅱdegree retinal hemorrhage , while the other 92 cases were Ⅲ~Ⅳdegree retinal hemorrhage .Multivariate logistic regression analysis showed that maternal thrombocytopenia , vaginal delivery and suffocation were the risk factors of RH , meanwhile maternal thrombocytopenia and suffocation were associated with the presence of severe RH ( P<0.05).There was no statistical difference of the degree of RH between the mild and severe asphyxia infants .Conclusion Maternal thrombocytopenia was a risk factor of RH and associated with the occurrence of severe RH .Meanwhile, vaginal delivery,suffocation were also risk factors of RH .