Doi Koutarou, Sameshima Hiroshi, Kodama Yuki, Furukawa Seishi, Kaneko Masatoki, Ikenoue Tsuyomu
Department of Obstetrics and Gynecology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
J Matern Fetal Neonatal Med. 2012 Jun;25(6):706-9. doi: 10.3109/14767058.2011.587061. Epub 2011 Jul 5.
We investigated the risk factors of perinatal death and neurological damage.
Perinatal death and neurological damage were retrospectively investigated using a population-based study of 108 024 deliveries from 1998 to 2007. Main factors studied were asphyxia, growth restriction and preterm delivery < 34 weeks of gestation, since these three factors were most often associated with poor prognosis. The impact of each factor was identified by multiple regression analyses.
There were 459 perinatal deaths (4.3/1000) and 220 neurological damages (2.0/1000). Preterm delivery accounted for 50% of perinatal deaths and neurological damage, whereas it constituted 2.6% of total births. Multiple regression analyses showed that prematurity < 34 weeks (10-fold), asphyxia (10-fold) and growth restriction (2-fold) were independent and significant risk factors associated with poor outcomes, and that the magnitude was similar throughout the three consecutive critical events of fetal death, neonatal death and neurological damage.
Prematurity < 34 weeks, asphyxia and growth restriction are independent and persistent risk factors from perinatal death to neurological damage.
我们调查了围产期死亡和神经损伤的危险因素。
采用基于人群的研究方法，对1998年至2007年期间108024例分娩进行回顾性调查，以研究围产期死亡和神经损伤情况。所研究的主要因素为窒息、生长受限以及孕周小于34周的早产，因为这三个因素最常与不良预后相关。通过多元回归分析确定每个因素的影响。
共有459例围产期死亡（4.3/1000）和220例神经损伤（2.0/1000）。早产占围产期死亡和神经损伤的50%，而其在总出生数中占2.6%。多元回归分析显示，孕周小于34周（10倍）、窒息（10倍）和生长受限（2倍）是与不良结局相关的独立且显著的危险因素，并且在胎儿死亡、新生儿死亡和神经损伤这三个连续的关键事件中其影响程度相似。
孕周小于34周的早产、窒息和生长受限是从围产期死亡到神经损伤的独立且持续存在的危险因素。
