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孕龄32至36周婴儿早产儿视网膜病变的危险因素

[Risk factors of retinopathy of prematurity in infants 32 to 36 weeks gestational age].

作者信息

Gleissner M W, Spantzel T, Bücker-Nott H-J, Jorch G

机构信息

Kinderzentrum der Krankenanstalten Gilead GmbH Bethel, Bielefeld.

出版信息

Z Geburtshilfe Neonatol. 2003 Jan-Feb;207(1):24-8. doi: 10.1055/s-2003-37841.

Abstract

INTRODUCTION

In our study we determined possible risk factors for retinopathy of prematurity (ROP) in infants 32 to 36 completed weeks of gestational age based on a regional German neonatal database. We examined especially whether or not oxygen therapy over more than 3 days is related to a higher risk of ROP.

MATERIALS

We identified 7172 ophthalmologically examined infants, 32 to 36 completed weeks gestational age, born from 1990 to 1996. ROP was diagnosed in 195 (2.7 %). We examined the following variables as risk factors for ROP in infants receiving oxygen for less than 4 days: gestational age, sex, blood pH of 7.0 or less, body temperature of 36 degrees C or less, phototherapy, blood pO2 of 35 mm Hg or less, small-for-gestational age, sepsis, ventilation after birth, and blood transfusion.

RESULTS

Sex, blood pH of 7.0 or less, blood pO2 of 35 mm Hg or less, sepsis, phototherapy, and small-for-gestational age were not associated with a significant risk of ROP. A gestational age of 32 weeks compared to a gestational age of 36 weeks was associated with an increased risk of ROP (odds ratio, 2.95; 95 % confidence interval, 2.18 to 4.01). Ventilation after birth (adjusted OR, 2.29; 95 % CI, 1.70 to 3.15) and blood transfusion (adjusted OR, 5.28; 95 % CI, 3.80 to 7.23) increased the risk of ROP regardless of gestational age. Oxygen therapy for more than 3 days was not associated with an increased risk of ROP (OR, 1.06; 95 % CI, 0.67 to 1.70).

CONCLUSION

In neonates delivered between 32 and 36 weeks of gestation, the duration of oxygen supplementation should not necessitate an ophthalmological examination. A vigorous restriction of blood transfusions could reduce the incidence of ROP.

摘要

引言

在我们的研究中,我们基于德国一个地区性的新生儿数据库,确定了孕龄32至36足周婴儿发生早产儿视网膜病变(ROP)的可能危险因素。我们特别研究了超过3天的氧疗是否与更高的ROP风险相关。

材料

我们确定了7172名接受眼科检查的婴儿,其孕龄为32至36足周,出生于1990年至1996年。195名(2.7%)婴儿被诊断为ROP。我们将以下变量作为接受氧疗少于4天婴儿发生ROP的危险因素进行研究:孕龄、性别、血pH值7.0或更低、体温36摄氏度或更低、光疗、血pO2 35毫米汞柱或更低、小于胎龄儿、败血症、出生后通气和输血。

结果

性别、血pH值7.0或更低、血pO2 35毫米汞柱或更低、败血症、光疗和小于胎龄儿与ROP的显著风险无关。孕龄32周与孕龄36周相比,ROP风险增加(比值比,2.95;95%置信区间,2.18至4.01)。无论孕龄如何,出生后通气(校正后OR,2.29;95%CI,1.70至3.15)和输血(校正后OR,5.28;95%CI,3.80至7.23)都会增加ROP风险。超过3天的氧疗与ROP风险增加无关(OR,1.06;95%CI,0.67至1.70)。

结论

对于孕32至36周出生的新生儿,氧疗时间不一定需要进行眼科检查。严格限制输血可以降低ROP的发生率。

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