未足月胎膜早破后早产儿脑损伤的相关危险因素分析

目的:分析未足月胎膜早破后早产儿脑损伤的高危因素。方法:对2008年1月～2010年10月在医院产科出生且生后即转入新生儿科的未足月胎膜早破后早产儿及母亲的临床资料进行回顾性分析,按早产儿生后有无脑损伤分为脑损伤组与无脑损伤组。对患儿胎龄、出生体质量、性别、母亲有无绒毛膜羊膜炎、羊水指数、母亲产前应用激素、破膜时间、分娩方式、胎儿宫内窘迫、窒息复苏10个项目进行分析。结果:137例早产儿符合研究标准,未足月胎膜早破后早产儿脑损伤发生率24.8%。早产儿脑损伤危险因素Logistic回归分析按OR值排序,依次为胎龄、出生体重、窒息复苏及母亲绒毛膜羊膜炎。破膜时间长短与脑损伤无关。结论:未足月胎膜早破后早产儿脑损伤的发生与多因素有关,胎龄越小、体重越低脑损伤发生率越高,母亲绒毛膜羊膜炎及患儿生后有窒息复苏史也为早产儿脑损伤高危因素。

Analysis of risk factors for brain injury in preterm infants after preterm premature rupture of membranes

Objective:To explore the high risk factors of brain injury in preterm infants after preterm premature rupture of membranes.Methods:Data were collected retrospectively among preterm infants after preterm premature rupture of membranes who were borne in obstetrics and admitted to neonatal intensive care unit in our hospital from Jan.2008 to Oct.2010.All subjects were divided into brain injury group and no brain injury group.Logistic regression was adopted to analyze 10 factors: gestational age,birth weigh,sex,mother chorioamnionitis,amniotic fluid index,antenatal steroids therapy to mothers,latency after preterm premature rupture of membranes,delivery ways,fetal distress in uterus,asphyxiate resuscitation.Results:Among 137 preterm infants,33 cases(24.8%) were detected with brain injury.Risk factors for brain injury in preterm infants after preterm premature rupture of membranes were arranged as follows according to odds ratio(OR) value: gestational age,birth weigh,asphyxiate resuscitation,and mother chorioamnionitis.There was no relationship between neonatal brain damage and latency interval after preterm premature rupture of membranes.Conclusion:Many factors are associated with brain injury in preterm infants after preterm premature rupture of membranes.The smaller gestational age and the lower birth weight,the higher the incidence of brain injury Asphyxiate resuscitation and mother chorioamnionitis are all the high risk factors of brain injury in premature infants.