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与宫内生长受限相关或不相关的晚期早产儿的新生儿结局

Neonatal outcomes of late-preterm birth associated or not with intrauterine growth restriction.

作者信息

Ortigosa Rocha Cristiane, Bittar Roberto Eduardo, Zugaib Marcelo

机构信息

Department of Obstetrics, University of Sao Paulo, Av. dr Eneas de Carvalho Aguiar, 945, Cerqueira Cesar, Sao Paulo SP, cep 05412-002, Brazil.

出版信息

Obstet Gynecol Int. 2010;2010:231842. doi: 10.1155/2010/231842. Epub 2010 Mar 22.

Abstract

Objective. To compare neonatal morbidity and mortality between late-preterm intrauterine growth-restricted (IUGR) and appropriate-for-gestational-age (AGA) infants of the comparable gestational ages (GAs). Methods. We retrospectively analyzed neonatal morbidity and mortality of 50 singleton pregnancies involving fetuses with IUGR delivered between 34 and 36 6/7 weeks of GA due to maternal and/or fetal indication. The control group consisted of 36 singleton pregnancies with spontaneous preterm delivery at the same GA, in which the infant was AGA. Categorical data were compared between IUGR and AGA pregnancies by X(2) analysis and Fisher's exact test. Ordinal measures were compared using the Kruskal-Wallis test. Results. The length of stay of newborns in the nursery, as well as the need for and duration of hospitalization in the neonatal intensive care unit, was longer in the group with IUGR. Transient tachypnea of the newborn or apnea rates did not differ significantly between the IUGR and AGA groups. IUGR infants were found to be at a higher risk of intraventricular hemorrhage. No respiratory distress syndrome, pulmonary hemorrhage or bronchopulmonary dysplasia was observed in either group. The frequency of sepsis, thrombocytopenia and hyperbilirubinemia was similar in the two groups. Hypoglycemia was more frequent in the IUGR group. No neonatal death was observed. Conclusion. Our study showed that late-preterm IUGR infants present a significantly higher risk of neonatal complications when compared to late-preterm AGA infants.

摘要

目的。比较孕龄相当的晚期早产儿宫内生长受限(IUGR)与适于胎龄(AGA)婴儿的新生儿发病率和死亡率。方法。我们回顾性分析了50例单胎妊娠,这些妊娠因母体和/或胎儿指征在孕34至36 6/7周分娩出患有IUGR的胎儿。对照组由36例在相同孕龄自发早产的单胎妊娠组成,其婴儿为AGA。通过X²分析和Fisher精确检验比较IUGR与AGA妊娠之间的分类数据。使用Kruskal-Wallis检验比较有序指标。结果。IUGR组新生儿在新生儿重症监护病房的住院时间更长,住院需求和住院时间也更长。IUGR组与AGA组新生儿短暂性呼吸急促或呼吸暂停发生率无显著差异。发现IUGR婴儿发生脑室内出血的风险更高。两组均未观察到呼吸窘迫综合征、肺出血或支气管肺发育不良。两组败血症、血小板减少症和高胆红素血症的发生率相似。IUGR组低血糖更常见。未观察到新生儿死亡。结论。我们的研究表明,与晚期早产AGA婴儿相比,晚期早产IUGR婴儿出现新生儿并发症的风险显著更高。

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