胎膜早破对产妇感染及早产儿结局的影响
[Effect of premature rupture of membranes on maternal infections and outcome of preterm infants].
作者信息
Wu Tian, Shi Jing, Bao Shan, Qu Yi, Mu De-Zhi
机构信息
Department of Pediatrics, West China Second University Hospital/Key Laboratory of Obstetric and Gynecologic and Pediatric Diseases and Birth Defects of Ministry of Education, Sichuan University, Chengdu 610041, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2017 Aug;19(8):861-865. doi: 10.7499/j.issn.1008-8830.2017.08.004.
OBJECTIVE
To investigate the effect of premature rupture of membranes (PROM) on maternal infections and outcome of preterm infants.
METHODS
A total of 441 preterm infants and 387 mothers were enrolled as subjects. According to the presence or absence of PROM, the mothers were divided into non-PROM group with 104 mothers, PROM duration <72 hours group with 90 mothers, and PROM duration ≥72 hours group with 193 mothers. The three groups were compared in terms of clinical features of mothers and infants and complications.
RESULTS
Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher maternal age, incidence rate of umbilical vasculitis, and rate of antibiotic use; the PROM duration ≥72 hours group had a significantly higher incidence rate of moderate-to-severe chorioamnionitis than the control group (P<0.05), while there was no significant difference between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). Compared with the control group and the PROM duration <72 hours group, the PROM duration ≥72 hours group had significantly higher incidence rates of pneumonia and intracranial hemorrhage in preterm infants; the PROM duration ≥72 hours group had a significantly higher incidence rate of congenital infection and a significantly longer mean length of hospital stay compared with the control group (P<0.05), while there were no significant differences between the PROM duration ≥72 hours group and the PROM duration <72 hours group (P>0.05). The multivariate analysis showed that PROM duration ≥72 hours was an independent risk factors for pneumonia (OR=2.200, 95%CI: 1.386-3.492) and intracranial hemorrhage (OR=2.331, 95%CI: 1.420-3.827) in preterm infants.
CONCLUSIONS
PROM duration ≥72 hours significantly increases the risk of placental infection in mothers and it is an independent risk factor for pneumonia and intracranial hemorrhage in preterm infants.
目的
探讨胎膜早破（PROM）对孕产妇感染及早产儿结局的影响。
方法
共纳入441例早产儿及387例母亲作为研究对象。根据是否发生胎膜早破，将母亲分为未发生胎膜早破组104例、胎膜早破持续时间<72小时组90例、胎膜早破持续时间≥72小时组193例。比较三组母婴临床特征及并发症情况。
结果
与对照组和胎膜早破持续时间<72小时组相比，胎膜早破持续时间≥72小时组产妇年龄、脐血管炎发生率、抗生素使用率显著更高；胎膜早破持续时间≥72小时组中重度绒毛膜羊膜炎发生率显著高于对照组（P<0.05），而胎膜早破持续时间≥72小时组与胎膜早破持续时间<72小时组之间差异无统计学意义（P>0.05）。与对照组和胎膜早破持续时间<72小时组相比，胎膜早破持续时间≥72小时组早产儿肺炎及颅内出血发生率显著更高；胎膜早破持续时间≥72小时组先天性感染发生率显著高于对照组，平均住院时间显著长于对照组（P<0.05），而胎膜早破持续时间≥72小时组与胎膜早破持续时间<72小时组之间差异无统计学意义（P>0.05）。多因素分析显示，胎膜早破持续时间≥72小时是早产儿肺炎（OR=2.200，95%CI：1.386-3.492）及颅内出血（OR=2.331，95%CI：1.420-3.827）的独立危险因素。
结论
胎膜早破持续时间≥72小时显著增加母亲胎盘感染风险，是早产儿肺炎及颅内出血的独立危险因素。
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