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[晚期早产儿:胎儿性别对新生儿结局的影响]

[Late preterms: the influence of foetal gender on neonatal outcome].

作者信息

Herz K, Wohlmuth P, Liedtke B, Schmidt S, Hackelöer B J, Hellmeyer L

机构信息

Asklepios proresearch, Hamburg.

出版信息

Z Geburtshilfe Neonatol. 2012 Jun;216(3):141-6. doi: 10.1055/s-0032-1309050. Epub 2012 Jun 21.

Abstract

BACKGROUND

The group of the so-called late preterms (infants born at 34 0/7-36 6/7 weeks gestational age) has been underestimated with respect to their neonatal outcome. Among infants born before the 29th week of pregnancy, a gender-specific difference in favour of females regarding morbidity became evident. The aim of this study is to investigate whether these findings are transferable to the group of late preterms.

METHODS

The neonatal outcome of 528 consecutive singletons, born at 34 0/7-36 6/7 weeks gestational age and requiring intensive care, was examined.

RESULTS

Neonatal complications have been particularly analysed with regard to gender-specific differences. Boys (n=292) were significantly more frequently affected by sepsis (3.8 vs. 0.9%; p=0,0314, x²-test). Girls had significantly longer stays in the neonatal intensive care unit (median 12 (Q1:8; Q3:17) vs. 11 (6;16) days; p=0.0149, t-test). In a multiple logistic regression model, male gender and premature rupture of membranes were borderline significant with respect to the occurrence of sepsis - boys had a 4.4-fold risk (OR=0.228 [95% CI: 0.050-1.041]; p=0.0564) and premature rupture of membranes had a 3.5-fold risk (OR=3.462 [0.938-12.779]; p=0.0623). Strong cause variables for the length of stay in the neonatal intensive care unit were birth weight, gestational age and premature rupture of membranes after adjustment.

CONCLUSION

The influence of foetal gender on the neonatal outcome in the late preterm group (34 0/7-36 6/7 gestational age) has been relativised.

摘要

背景

所谓晚期早产儿(孕龄为34⁰/₇ - 36⁶/₇周出生的婴儿)群体的新生儿结局一直被低估。在妊娠29周前出生的婴儿中,在发病率方面有利于女性的性别差异变得明显。本研究的目的是调查这些发现是否可应用于晚期早产儿群体。

方法

检查了528例连续的单胎婴儿的新生儿结局,这些婴儿孕龄为34⁰/₇ - 36⁶/₇周且需要重症监护。

结果

特别分析了新生儿并发症的性别差异。男孩(n = 292)患败血症的频率明显更高(3.8%对0.9%;p = 0.0314,卡方检验)。女孩在新生儿重症监护病房的住院时间明显更长(中位数12(第一四分位数:8;第三四分位数:17)天对11(6;16)天;p = 0.0149,t检验)。在多元逻辑回归模型中,男性性别和胎膜早破在败血症发生方面接近显著——男孩有4.4倍风险(比值比 = 0.228 [95%置信区间:0.050 - 1.041];p = 0.0564),胎膜早破有3.5倍风险(比值比 = 3.462 [0.938 - 12.779];p = 0.0623)。调整后,新生儿重症监护病房住院时间的强相关因素是出生体重、孕龄和胎膜早破。

结论

胎儿性别对晚期早产儿组(孕龄34⁰/₇ - 36⁶/₇周)新生儿结局的影响已相对化。

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