吸毒孕妇所生新生儿临床结局分析

目的 分析吸毒孕妇围生儿的临床结局.方法 回顾性分析105例吸毒孕妇所生新生儿的临床资料,包括早产儿、低体重儿、新生儿窒息、新生儿呼吸窘迫综合征(neonatal respiratory distress syndrome,NRDS)、颅内出血、先天畸形及死亡,并与50例健康孕妇所生的新生儿(对照组)进行比较,同时观察新生儿戒断综合征的发生情况.结果 105例吸毒孕妇中,自然分娩80例,剖宫产25例.早产56例(53.3％),平均出生体重(2 534±1 234)g,新生儿窒息25例(23.8％),NRDS 18例(17.1％),颅内出血16例(15.2％),先天畸形3例(2.9％).吸毒孕妇所生新生儿胎龄及出生体重低于对照组,吸毒孕妇围生儿发生早产、低体重儿、新生儿窒息、NRDS及颅内出血的比例高于对照组,差异有统计学意义(P＜0.05).与吸毒时间≤2年者比较,吸毒时间＞2年者所生新生儿早产、低体重儿、新生儿窒息、NRDS的比例更高,差异有统计学意义(P＜0.05).静脉注射吸毒孕妇发生早产、低体重儿、新生儿窒息、NRDS的比例高于口服吸毒者,差异有统计学意义(P＜0.05).吸毒组新生儿红细胞、白细胞、天门冬氨酸氨基转移酶、丙氨酸转氨酶高于对照组,血小板及白蛋白低于对照组,差异有统计学意义(P＜0.05).共30例新生儿出现新生儿戒断综合征表现.105例新生儿中治愈99例,死亡6例,死亡原因包括3例NRDS合并肺部感染,1例严重颅内出血,1例窒息,1例多器官功能衰竭.结论 吸毒会导致新生儿早产增加,窒息及NRDS的比例升高.妊娠晚期吸毒会导致新生儿戒断综合征.

Clinical outcome analysis of newborn in pregnant women with drug abuse

Objective To observe the pregnancy outcome of perinatal in drugs abuse pregnant women.Methods The clinical data of 105 cases of newborn in pregnant women with drug abuse were analyzed retrospectively,including premature,neonatal asphyxia,low birth weight,neonatal respiratory distress syndrome (NRDS),intracranial hemorrhage,neonatal congenital malformation and death.Fifty cases of newborn of healthy pregnant women were selected as control group.The occurrence of neonatal withdrawal syndrome was observed.Results There were 80 cases of natural labor,25 cases of cesarean section in 105 cases of pregnant women with drug abuse.Among them,56 cases (53.3 ％) of premature delivery,the average birth weight was(2 534 ± 1 234) g,25 cases(23.8％) of neonatal asphyxia,18 cases(17.1％) of neonatal respiratory distress syndrome (NRDS),16 cases (15.2 ％) of intracranial hemorrhage,and 3 cases (2.9 ％) of congenital malformation.The gestational age and weight of newborn with maternal drug abusing were significantly lower than those of the control group,the incidence of premature infants,low birth weight infants,neonatal asphyxia,NRDS and intracranial hemorrhage were higher than those of the control group,and the differences were significant (P ＜ 0.05).Compared with drug abuse less than 2 years,the proportion of preterm infants,low birth weight,neonatal asphyxia and NRDS were higher than those of drug abuse more than 2 years(P ＜0.05).The proportion of preterm infants,low birth weight,neonatal asphyxia and NRDS of intravenous drug users were higher than those of oral drug users,the differences were significant (P ＜ 0.05).The red blood cellcount,aspartate amino transferase,white blood cellcount and alanine aminotransferase in the drug abusing group were higher than those in the control group,platelet and albumin were lower than those in the control group (P ＜0.05).A total of 30 neonates had the manifestations of neonatal withdrawal syndrome.In 105 cases of newborns,99 cases cured,6 cases died,the cure rate was 94.3％.The causes of death included 3 cases of NRDS complicated with pulmonary infection,1 case of severe intracranial hemorrhage,1 case of asphyxia,and 1 case of multiple organ failure.Conclusion Drug abuse can lead to the increase of premature birth rate,asphyxiation and NRDS.Late pregnant women with drug abuse can cause the incidence of neonatal withdrawal syndrome.