比较新生儿出生窒息的（早期）结局与分娩地点及入院时年龄的关系。

To compare the outcome (early) of neonates with birth asphyxia in-relation to place of delivery and age at time of admission.

作者信息

Memon Shazia, Shaikh Salma, Bibi Seema

机构信息

Department of Paediatrics, Liaquat University of Medical & Health Sciences, Jamshoro, Hyderabad.

出版信息

J Pak Med Assoc. 2012 Dec;62(12):1277-81.

PMID:23866472

Abstract

OBJECTIVE

To determine the frequency of birth asphyxia and short-term (early) outcome in relation to age at admission and place of delivery.

METHODS

A descriptive cross-sectional study was conducted in the Paediatric Department, Neonatal Ward of Liaquat University Hospital (LUH) Hyderabad from January to December 2009. All babies were received at our nursery or delivered in LUH with birth asphyxia were included, while babies having major congenital abnormalities, with birth weight < 1800 gm or preterm were excluded. After consent and enrollment their detailed history including peri-natal history, Apgar score, resuscitation measures, problems and outcome were recorded on a pre-designed study proforma. Short-term outcome was measured after 7 hours as clinically improved, developed neurological disability (Hypoxic Ischaemic Encephalopathy stage II or III) or death.

RESULTS

The frequency was (n = 600; 25%) of LUMHS born and (n = 310; 61.63%) were received within 6 hours, (n = 272 45% were LUMHS born and n = 7 7% were out born), (n = 37; 38.95%) within 24 hours and (n = 9; 10.3%) after 24 hours. On initial neurological evaluation (n = 90; 15%) were normal while clinical signs of HIE were present in 85%, with (n = 180; 30%) in stage I, (n = 210; 35%) in Stage II and (n = 120; 20%) in stage III of HIE. Outcome was measured after 72 hours, around 53.3% (320) were normal, 31.6% (190) developed neurological disability, while 15% (90) babies expired. Outcome was better in Liaquat University of Medical Health Sciences (LUMHS) born than out-born with statistically significant difference in terms of disability (Chi-square test P-value < 0.0001) but no difference was noted in terms of disability to death. There was a statistically improved outcome for babies received within 6 hours than those after 6 hours of birth (Chi-square test P-value < 0.0255).

CONCLUSION

Early recognition of birth asphyxia and timely referral to tertiary center can reduce morbidity and mortality.

摘要

目的

确定出生窒息的发生率以及与入院时年龄和分娩地点相关的短期（早期）结局。

方法

2009年1月至12月在海得拉巴利亚卡特大学医院（LUH）儿科新生儿病房进行了一项描述性横断面研究。纳入所有在我们新生儿重症监护室接收或在LUH分娩且患有出生窒息的婴儿，排除患有严重先天性异常、出生体重<1800克或早产的婴儿。在获得同意并登记后，将他们的详细病史，包括围产期病史、阿氏评分、复苏措施、问题和结局记录在预先设计的研究表格上。72小时后测量短期结局，分为临床症状改善、出现神经功能障碍（缺氧缺血性脑病II期或III期）或死亡。

结果

在LUMHS出生的婴儿发生率为（n = 600；25%），其中（n = 310；61.63%）在6小时内入院，（n = 272；45%）在LUMHS出生，（n = 7；7%）为院外出生，（n = 37；38.95%）在24小时内入院，（n = 9；10.3%）在24小时后入院。初始神经评估时，（n = 90；15%）正常，85%存在HIE临床体征，其中HIE I期（n = 180；30%），II期（n = 210；35%），III期（n = 120；20%）。72小时后测量结局，约53.3%（320）正常，31.6%（190）出现神经功能障碍，15%（90）婴儿死亡。在LUMHS出生的婴儿结局优于院外出生的婴儿，在神经功能障碍方面有统计学显著差异（卡方检验P值<0.0001），但在神经功能障碍与死亡方面无差异。出生后6小时内入院的婴儿结局在统计学上优于6小时后入院的婴儿（卡方检验P值<0.0255）。