产科因素对新生儿窒息的影响

目的:探讨新生儿窒息的产科高危因素。方法:以2002年1月～2007年12月在我院进行产前检查的孕妇及其分娩的8428例单胎活产新生儿为研究对象,采用回顾性队列研究方法探讨常见产科因素对新生儿窒息的影响。结果:在8428例单胎活产新生儿中,共发生窒息304例(3.61%)。多因素Cox-回归模型分析结果显示,可独立增加新生儿窒息发病风险的产科因素相对危险度及95%CI分别为:胎盘早剥5.54(2.28～13.46)、前置胎盘1.85(1.05～3.24)、羊水过多2.55(1.35～4.83)、臀位3.45(2.45～4.86)、枕横位3.68(2.50～5.42)、脐带供血障碍1.49(1.16～1.92)。结论:胎盘早剥、臀位、枕横位、羊水过多、前置胎盘和脐带供血障碍是导致新生儿窒息的重要产科因素,产前、产时应密切关注这些因素,以减少新生儿窒息的发生。

The effect of obstetrical factors on neonate asphyxia

Objective:To explore the obstetrical risk factors of neonate asphyxia.Methods:From January 2002 to December 2007,a retrospective cohort study was carried out with 8 428 neonates and their mothers.The obstetrical risk factors of neonate asphyxia were surveyed.Results:Among 8 428 singleton pregnancy neonates,the rate of asphyxia was 3.61%(304 cases).Multivariate Cox-regression analysis showed that the relative risk degree and 95% confidence interval of the independent risk factors were placental abruption 5.54(2.28～13.46),placenta praevia 1.85(1.05～3.24),polyhydramnios 2.55(1.35～4.83),breech presentation 3.45(2.45～4.86),occiput transverse position 3.68(2.50～5.42) and insufficient umbilical blood flow 1.49(1.16～1.92).Conclusion:Placental abruption,placenta praevia,polyhydramnios,breech presentation,occiput transverse position and insufficient umbilical blood flow are important obstetrical risk factors of neonate asphyxia.More attention should be paid to these risk factors during antepartum and intrapartum to decrease risk of neonate asphyxia.