极低出生体重儿临床相关因素及与预后的关系

目的探讨极低出生体重儿的围产期及临床特点,分析其与预后的关系.方法分析110例极低出生体重儿(含12例超低出生体重儿)的一般情况、产科及母孕期情况、新生儿临床特点.结果胎龄小于32w者占79%,小于胎龄儿占17.3%,41%为多胎;32%有胎膜早破史,18%母亲有妊高征;36%有窒息复苏史;产科异常是胎儿早产的主要原因.呼吸暂停、低体温、高胆红素血症及低血糖是常见的并发症;多胎、围产期异常及小于胎龄儿是极低出生体重儿主要死亡原因,生于院内或转运者死亡率明显低于院外出生者(P<0.01).结论加强对高危孕妇及新生儿的监护,普及新生儿窒息复苏知识,将有助于改善极低出生体重儿的预后.

Relationship between the clinical relative factors and prognosis in the infants born with very low birth weight

Objective:To understand the perinatal and clinical aspects in infants born with very low birth weight(VLBW) and their relationship with the survival. Methods:110 VLBW infants were analysed with the general, obstetrical and their mothers as well asthe clinical aspects. Results: Among them, 79% were bom less than 32 weeks gestational ages,17% were small for gestational age, 41% were multiple gestations. 32% with membrane rupture, and 18% mothers with pregnancy hypertension syndrome. 36% required resuscitation at birth. Apnea of prematurity, hypothermia, hyperbilirubin and hypoglycemia were the most common neonatal complications. The morbidity outborn was significantly higher than that inborn or transported(P<0.01). Conclusion: The perinatal and neonatal care and neonatal resuscitation programs need to be emphasized to improve the outcome of VLBW infants.