Chaturvedi P, Shah N
Department of Pediatrics, M.G. Institute of Medical Sciences, Sevagram, Wardha.
Indian J Pediatr. 1991 Jan-Feb;58(1):63-7. doi: 10.1007/BF02810413.
A prospective study was conducted on consequitively born live births for determining the role of certain foetal factors and mode of delivery on asphyxia neonatorum. The difference in the incidence of neonatal asphxia in 1208 singleton births (8.5%) and in the 66 multiple births (9.7%) was statistically significantly (p less than 0.01). Among the singleton live births a significantly increased incidence of asphyxia was recorded in preterms when compared to term and post term babies collectively (p less than 0.001). Small for date babies were at a greater risk for asphxia neonatorum when compared to babies weighing appropriate for gestational age (p less than 0.001). An inverse relationship was observed between birth weight and asphyxia neonatorum. A significant difference was seen in the occurrence of neonatal asphyxia between babies weighing less than 2000 g. and those weighing more than 2000 g. (p less than 0.001). The incidence was significantly influenced by mode of delivery, being highest in vaginal breech delivery followed in decreasing frequency by forceps and normal vaginal delivery. Among vaginal breech delivered neonates those weighing greater than or equal to 2500 g were at the highest risk. Evidence of foetal distress and meconium stained amniotic fluid had a low predictability of asphyxia being 35.0% and 40.0% respectively though both were statistically significant (p less than 0.001).
对连续出生的活产婴儿进行了一项前瞻性研究,以确定某些胎儿因素和分娩方式对新生儿窒息的作用。1208例单胎分娩(8.5%)和66例多胎分娩(9.7%)中新生儿窒息发生率的差异具有统计学意义(p<0.01)。在单胎活产中,与足月儿和过期产儿合计相比,早产儿窒息发生率显著增加(p<0.001)。与出生体重适合孕周的婴儿相比,小于胎龄儿发生新生儿窒息的风险更大(p<0.001)。观察到出生体重与新生儿窒息之间呈负相关。体重小于2000g的婴儿与体重大于2000g的婴儿在新生儿窒息发生率上存在显著差异(p<0.001)。分娩方式对窒息发生率有显著影响,阴道臀位分娩发生率最高,其次是产钳助产和正常阴道分娩,发生率依次降低。在阴道臀位分娩的新生儿中,体重≥2500g的婴儿风险最高。胎儿窘迫和羊水粪染对窒息的预测性较低,分别为35.0%和40.0%,尽管两者均具有统计学意义(p<0.001)。