天津医药 ›› 2019, Vol. 47 ›› Issue (3): 284-287.doi: 10.11958/20181778

• 临床研究 • 上一篇    下一篇

体质量≥2 500 g小于胎龄儿相关危险因素及围产结局分析

赵采云,华绍芳   

  1. 天津医科大学第二医院产科(邮编300211)
  • 收稿日期:2018-11-16 修回日期:2019-02-05 出版日期:2019-03-15 发布日期:2019-04-24
  • 通讯作者: 赵采云 E-mail:guqiuyun@sina.cn

The risk factors and perinatal outcome for birth weight ≥2 500 g infants small than gestational age

ZHAO Cai-yun,HUA Shao-fang   

  1. Department of Obstetrics, the Second Hospital of Tianjin Medical University, Tianjin 300211, China
  • Received:2018-11-16 Revised:2019-02-05 Published:2019-03-15 Online:2019-04-24
  • Contact: ZHAO caiyun E-mail:guqiuyun@sina.cn

摘要: 目的 分析出生体质量≥2 500 g小于胎龄儿(SGA)的相关危险因素以及其围产结局。方法 选取2013年1月1日—2018年4月8日于本院产科出生的体质量≥2 500 g SGA 183例为病例组,另择同期出生的≥2 500 g适于胎龄儿(AGA)183 例为对照组,比较 2 组影响新生儿出生体质量的主要相关因素,包括母亲因素[孕妇体质量指数(BMI)、合并症等],胎儿因素(性别、胎次等),胎盘脐带因素;并对围产期是否发生胎窘、羊水减少、新生儿疾患等临床数据进行对比分析。结果 病例组孕母BMI低于对照组,脐带胎盘异常、女婴和第1胎比例均高于对照组(P< 0.05)。Logistic 回归分析结果显示,胎盘脐带异常、女婴、第 1 胎是导致≥2 500 g SGA 发生的主要危险因素,孕母高 BMI 是≥2 500 g SGA 的保护因素;≥2 500 g SGA 围产期羊水过少、胎儿宫内窘迫、出生缺陷的发生率明显高于≥2 500 g AGA(P<0.05)。结论 ≥2 500 g小于胎龄儿的危险因素及围产结局具有特殊性,有望通过加强孕期、围产期筛查与指导,密切监控高危因素,以减少其发生、改善预后。

关键词: 婴儿, 出生时低体重, 小于胎龄儿, 适于胎龄儿, 高危因素, 围产结局

Abstract: Objective To determine the risk factors of birth weight ≥2 500 g infants small than gestational age (SGA) and the common adverse perinatal outcome. Methods A total of 183 infants with birth weight (≥2 500 g) less than gestational age in the Department of Obstetrics of our hospital from January 1, 2013 to April 8, 2018 were selected as the case group. Another 183 cases of appropriate for gestational age (AGA) infants with birth weight ≥2 500 g were selected as the control group. The related indexes affecting neonatal birth weight were compared between two groups, including maternal factors [maternal body mass index (BMI), pregnancy complications], fetal factors (sex, parity), placental and umbilical cord factors. The clinical data of fetal distress, amniotic fluid loss and neonatal diseases were analyzed by SPSS software version 19.0. Results The maternal BMI was less in case group than that of control group, while umbilical cord placenta abnormalities, the ratios of female infants and the first birth were higher in case group than those of the control group (P< 0.05). Logistic regression analysis showed that abnormal placenta and umbilical cord, female infants and first fetus were the main risk factors for SGA (≥ 2 500 g), and higher maternal BMI was the protective factor of SGA (≥2 500 g). The incidence of oligohydramnios, fetal distress and birth defects in SGA during perinatal period were significantly higher than those in AGA(≥ 2 500 g, P<0.05). Conclusion The risk factors and perinatal outcomes for infants (≥2 500 g SGA) have particularity. It is expected that high-risk factors can be closely monitored by strengthening screening and guidance during pregnancy and perinatal period to reduce the occurrence and improve prognosis.

Key words: infant, low birth weight, small for gestational age infant, appropriate for gestational age infant, risk factors, adverse perinatal outcome