Butt Tayyaba Khawar, Farooqui Rehan, Khan M Aman Ullah
Department of Paediatrics, The Services Institute of Medical Sciences, Lahore.
J Coll Physicians Surg Pak. 2008 Jul;18(7):428-32.
To determine underlying risk factors in neonates with hypoxic ischemic encephalopathy.
Case-control study.
Neonatology Unit at the Children's Hospital and the Institute of Childhealth, Lahore, from March to July 2005.
All neonates (153) with the diagnosis of Hypoxic Ischemic Encephalopathy (HIE) were included in the study. Controls (187) were selected from admissions on the same day. Possible risk factors such as maternal age, parity, antenatal monitoring, place of delivery, prolonged second stage of labour, type of delivery, type of attendant at delivery and the gestational age were noted and compared.
Sixty one (39.9%) mothers of asphyxiated babies reported no antenatal visits compared to 24.1% in the control group (OR 2.1, 95% CI 1.3-3.2; p=0.002). Only 6.5% of cases were born in government hospitals (teaching and district) in comparison to 20.9% of controls (OR 3.8, 95% CI 1.9-7.6; p=0.001). In 28.1% of cases, mothers had history of prolonged 2nd stage of labour in comparison to 5.9% of controls (OR 6.3, 95% CI 3.3-11.9; p<0.001). Fifty five cases (35.9%) were delivered by unskilled birth attendants compared to 28 (14.9%) controls (OR 3.2, 95% CI 1.9-5.3; p<0.001). No significant difference was found in maternal age, maternal parity, gestational age and the mode of delivery between the two groups.
Delivery by unskilled birth attendant, prolonged second stage of labour, birth in a non-government hospital setup and absence of antenatal care were significant risk factors for hypoxic ischemic encephalopathy in neonates. Improvement in antenatal and intrapartum care may be helpful in decreasing the frequency of this problem.
确定新生儿缺氧缺血性脑病的潜在危险因素。
病例对照研究。
2005年3月至7月，拉合尔儿童医院和儿童健康研究所新生儿科。
所有诊断为缺氧缺血性脑病（HIE）的新生儿（153例）纳入研究。对照组（187例）从同一天入院的患者中选取。记录并比较可能的危险因素，如产妇年龄、产次、产前监测、分娩地点、第二产程延长、分娩方式、分娩时的助产人员类型和孕周。
窒息婴儿的母亲中有61例（39.9%）报告未进行产前检查，而对照组为24.1%（比值比2.1，95%可信区间1.3 - 3.2；p = 0.002）。只有6.5%的病例在政府医院（教学医院和地区医院）出生，而对照组为20.9%（比值比3.8，95%可信区间1.9 - 7.6；p = 0.001）。28.1%的病例母亲有第二产程延长史，而对照组为5.9%（比值比6.3，95%可信区间3.3 - 11.9；p < 0.001）。55例（35.9%）由非专业助产人员接生，而对照组为28例（14.9%）（比值比3.2，95%可信区间1.9 - 5.3；p < 0.001）。两组在产妇年龄、产次、孕周和分娩方式方面未发现显著差异。
由非专业助产人员接生、第二产程延长、在非政府医院分娩以及缺乏产前护理是新生儿缺氧缺血性脑病的重要危险因素。改善产前和产时护理可能有助于降低该问题的发生率。
