晚期早产儿中小于胎龄儿的临床特点

目的探讨晚期早产儿中发生小于胎龄儿(SGA)的围产期因素及新生儿期患病特点。方法对2009年10月至2010年9月在我院新生儿重症监护病房住院、胎龄34～36周的晚期早产儿临床资料进行回顾性分析,比较晚期早产儿中SGA和适于胎龄儿(AGA)的围产期因素及新生儿期患病情况。结果 SGA组(179例)住院天数明显长于AGA组(851例)(16.4±6.2)天比(11.3±4.1)天,P<0.05]。SGA组母亲妊娠期高血压疾病(HDCP)、多胎妊娠、羊水过少和宫内窘迫的比例均高于AGA组(34.1%比17.9%,29.1%比13.7%,21.2%比12.6%,19.6%11.0%,P均<0.01)。SGA组患儿新生儿窒息、喂养不耐受、颅内出血、低血糖和红细胞增多症的发生率亦明显高于AGA组(12.8%比7.9%,7.8%比3.1%,6.1%比2.6%,27.4%比21.4%,3.4%比0.2%,P均<0.05)。结论母亲HDCP和多胎妊娠是造成晚期早产儿SGA的主要原因,SGA患儿相对于AGA患儿具有更高的患病风险,应针对造成SGA的围产期因素以及新生期疾病特点进行相应预防和干预。

Risk factors and neonatal morbidity of small for gestational age infants in late-preterm birth

Objective To compare perinatal risk factors and neonatal morbidity between late-preterm small-for-gestational-age(SGA) infants and appropriate-for-gestational-age(AGA) infants of the comparable gestational age(GA).Methods We retrospectively analyzed neonatal morbidity and perinatal factors of 179 infants with IUGR delivered between 34 and 36 weeks of GA due to maternal indication.The control group consisted of 851 infants with spontaneous preterm delivery at the same gestation,in which the infant was AGA.Results The birth weight in SGA group was significantly lower than that in AGA group(P<0.05).The length of stay of newborns in the nursery was longer in the group of SGA(P<0.05).The frequency of hypertensive disorder complicating pregnancy(HDCP),multiple pregnancy and oligohydramnios were higher in SGA group than those in AGA group(P all <0.01).SGA infants were found to be at a higher risk of intrauterine distress,birth asphyxia,feeding intolerance,intraventricular hemorrhage,hypoglycemia and polycythemia(P all <0.05).The incidence of respiratory distress syndrome,apnea,alimentary tract hemorrhage,aspiration syndrome and hyperbilirubinemia was similar in the two groups(P all >0.05).Conclusions Our study showed that late-preterm SGA infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.The perinatal factors of HDCP and multiple pregnancy had a higher incidence complicated with SGA.