国际妇产科学杂志

国际妇产科学杂志 ›› 2014, Vol. 41 ›› Issue (4): 434-437.

• 论著 • 上一篇    下一篇

2008—2012年1 466例早产回顾性临床分析

周欣，殷茵，张国英，孙丽洲   

  1. 210029 南京医科大学第一附属医院产科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2014-08-15 发布日期:2014-08-15
  • 通讯作者: 孙丽洲

Clinical Analysis of 1 466 Cases of Preterm Birth from 2008 to 2012

ZHOU Xin，YIN Yin，ZHANG Guo-ying，SUN Li-zhou   

  1. Department of Obstetrics，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China
  • Received:1900-01-01 Revised:1900-01-01 Published:2014-08-15 Online:2014-08-15
  • Contact: SUN Li-zhou

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摘要： 目的：探讨不同孕周和不同类型早产的变化趋势，及其与早产相关因素、分娩方式、早产儿出生体质量、新生儿窒息的关系。方法：回顾性分析2008年1月—2012年12月在南京医科大学第一附属医院住院分娩的早产病例1 466例，对不同孕周早产（妊娠早、中、晚期早产）和不同类型早产（自发性早产、治疗性早产）的变化趋势、早产相关因素、分娩方式、早产儿出生体质量及新生儿窒息率进行统计分析。结果：①2008—2012年早产的年发生率呈逐年升高趋势（χ2=65.69，P＜0.001），不同孕周早产发生率和不同类型早产发生率均呈升高趋势。②不同孕周自发性早产主要相关因素为胎膜早破、多胎妊娠、胎位异常、妊娠期糖尿病及不明原因等，不同孕周治疗性早产主要相关因素为妊娠期高血压疾病、胎盘因素、妊娠合并症、多胎妊娠、妊娠期肝内胆汁淤积症和胎儿窘迫等。③不同孕周早产的阴道分娩率和剖宫产率差异无统计学意义（P＞0.05），不同类型早产的阴道分娩率和剖宫产率差异有统计学意义（P＜0.05），治疗性早产剖宫产率高于自发性早产（P＜0.05）。④不同孕周早产的新生儿体质量和新生儿窒息率差异均有统计学意义（P＜0.05）。妊娠早期早产的新生儿窒息率（53.01%）高于中期早产（33.46%）和晚期早产（28.61%），差异有统计学意义（均P＜0.05），中期早产与晚期早产的新生儿窒息率差异无统计学意义（P＞0.05）。结论：应及早识别早产潜在高危因素，加强围生期管理，以减少早产的发生，改善围生儿结局。

关键词: 早产, 自然分娩, 剖宫产术, 回顾性研究

Abstract: Objective： To explore the variation tendency of different gestational weeks and types of prematurity and the relationship of preterm-related factors，mode of delivery，premature child birth weight and neonatal asphyxia. Methods：Retrospective analysis of 1 466 hospital delivery cases of preterm labor in the first Affiliated Hospital of Nanjing Medical University from January 2008 to December 2012. Statistical analysis of the tendency，the preterm-related factors，mode of delivery and the neonatal asphyxia of different gestational weeks of prematurity （early preterm，interim preterm，late preterm） and different types （spontaneous preterm birth，treatment of preterm labor）. Results：①From 2008 to 2012，the rate of preterm birth increased year by year（χ2=65.69，P＜0.001），while varying periods preterm showed an increasing trend，different types of preterm birth tended to increase. ②Varying periods of spontaneous preterm relevant factors include premature rupture of membranes，multiple pregnancy，abnormal fetal position，gestational diabetes some other unexplained factors and so on；the varying periods of therapeutic premature factors include gestational hypertension，placental factors，pregnancy complications，multiple pregnancy，intrahepatic cholestasis of pregnancy，fetal distress and so on. ③The vaginal delivery and cesarean section rate of different gestational weeks of preterm delivery was no significant difference （P＞0.05），while was statistically significant difference （P＜0.05） in different types of preterm delivery. The treatment of preterm cesarean section is higher than spontaneous preterm labor （P＜0.05）. ④The Birth weight and neonatal asphyxia varying different periods of preterm birth have been statistically significant（P＜0.05）, early preterm children with neonatal asphyxia （53.01%） higher than interim （33.46%，P＜0.05） and late preterm infants（28.61%，P＜0.05），no significant difference in interim and late preterm children（P＞0.05）. Conclusions：We should discriminate the preterm potential risk factors earlier and strengthen the perinatal management to reduce the incidence of preterm birth and improve the perinatal outcomes.

Key words: Premature birth, Natural childbirth, Cesarean section, Retrospective studies