Lu Hongyan, Wang Qiuxia, Lu Junyin, Zhang Qiang, Kumar Pravesh
Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China.
Department of Pediatrics, The Affiliated Hospital of Jiangsu University, Zhenjiang, Jiangsu Province, China.
J Stroke Cerebrovasc Dis. 2016 Apr;25(4):807-12. doi: 10.1016/j.jstrokecerebrovasdis.2015.12.011. Epub 2016 Jan 18.
The objective of this study is to identify possible perinatal risk factors related to intraventricular hemorrhage (IVH) in preterm infants born at 34 weeks of gestation or less following preterm premature rupture of membranes (pPROM).
A total of 292 preterm infants born at 34 weeks of gestation or less following pPROM were enrolled in the study, while 155 newborns with incomplete data, especially those that lack histological examination of the placenta, maternal details, and neonatal characteristics, have been further excluded. Finally, data of 137 preterm infants were included in the analysis. All infants underwent ultrasonographic screening for IVH. Thirty-three infants with IVH were considered as cases and 104 infants without IVH were considered as controls. The association between risk factors and IVH was evaluated by univariate and multivariate logistic regression analyses.
The incidence of IVH in preterm infants born at 34 weeks of gestation or less following pPROM was 24.1%, while the incidence of maternal chorioamnionitis was 43.8%. By univariate analysis, gestational age, birth weight, asphyxia resuscitation, maternal chorioamnionitis, fetal distress, amniotic fluid index, and latency of the rupture of membranes to birth were found to be significantly different between the 2 groups. By logistic regression analysis, lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis were found to be independent risk factors for IVH.
Lower gestational age, low birth weight, asphyxia resuscitation, and maternal chorioamnionitis are independent risk factors for IVH in preterm infants born at 34 weeks of gestation or less following pPROM.
本研究的目的是确定妊娠34周及以下胎膜早破(pPROM)出生的早产儿脑室内出血(IVH)的可能围产期危险因素。
本研究共纳入292例妊娠34周及以下pPROM出生的早产儿,另外155例数据不完整的新生儿,尤其是那些缺乏胎盘组织学检查、母亲详细信息和新生儿特征的新生儿被进一步排除。最终,137例早产儿的数据纳入分析。所有婴儿均接受IVH超声筛查。33例IVH婴儿被视为病例,104例无IVH婴儿被视为对照。通过单因素和多因素逻辑回归分析评估危险因素与IVH之间的关联。
妊娠34周及以下pPROM出生的早产儿IVH发生率为24.1%,而母亲绒毛膜羊膜炎发生率为43.8%。单因素分析发现,两组之间的胎龄、出生体重、窒息复苏、母亲绒毛膜羊膜炎、胎儿窘迫、羊水指数和胎膜破裂至出生的潜伏期有显著差异。逻辑回归分析发现,较低的胎龄、低出生体重、窒息复苏和母亲绒毛膜羊膜炎是IVH的独立危险因素。
较低的胎龄、低出生体重、窒息复苏和母亲绒毛膜羊膜炎是妊娠34周及以下pPROM出生的早产儿IVH的独立危险因素。