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一项使用回归分析各种因素的回顾性研究,探讨 24+0 至 36+6 周之间胎膜早破的单胎妊娠发生呼吸窘迫综合征的风险。

A Retrospective Study on the Risk of Respiratory Distress Syndrome in Singleton Pregnancies with Preterm Premature Rupture of Membranes between 24+0 and 36+6 Weeks, Using Regression Analysis for Various Factors.

机构信息

Department of Obstetrics and Gynecology in Ruda Slaska, Medical University of Silesia, Ruda Slaska, Poland.

Chair of Woman's Health, Medical University of Silesia, Katowice, Poland.

出版信息

Biomed Res Int. 2018 Oct 4;2018:7162478. doi: 10.1155/2018/7162478. eCollection 2018.

Abstract

AIM

This study aimed to investigate the cause of respiratory distress syndrome (RDS) in neonates from singleton pregnancies with preterm premature rupture of membranes (pPROM) between 24+0 and 36+6 weeks by using regression analysis for various factors.

METHODS

In 175 singleton pregnancies with pPROM, 95 cases of RDS (54,29%) were diagnosed. In all cases the following information was collected: latency period of PROM, gestational age at birth, Umbilical Artery Pulsatility Index (UA PI), Middle Cerebral Artery Pulsatility Index (MCA PI), fetal distress, antenatal steroids use, delivery type, pregnancy hypertension disease, gestational glucose intolerance or diabetes, neonatal laboratory parameters, gender, weight, Apgar score, and other neonatal complications. Logistic regression analysis was used to investigate the effect of variables on RDS.

RESULTS

The results of logistic regression analysis showed that the following variables are closely correlated with RDS: female gender (OR=0.52; 95%CI:0.28-0,97), antenatal steroids use (OR=0,46; 95%CI:0,34-0,64), abnormal UA PI and MCA PI (OR=2.96; 95%CI:1,43-6,12) (OR=2.05; 95%CI:1,07-3,95), fetal distress (OR=2.33; 95%CI:1,16-4,71), maternal HGB (OR=0.69; 95%CI:0,5-0,96), and neonatal RBC, HGB (OR=0.32; 95%CI:0,19-0,55) (OR=0.75; 95%CI:0,65-0,88).

CONCLUSIONS

The main RDS risk factors in premature neonates are gender, abnormal fetoplacental circulation, and fetal distress. The laboratory parameters such as lower RBC and HGB count are observed in infants with RDS.

摘要

目的

本研究旨在通过回归分析探讨各种因素对 24+0 至 36+6 周单胎妊娠胎膜早破早产儿呼吸窘迫综合征(RDS)的病因。

方法

在 175 例胎膜早破的单胎妊娠中,诊断出 95 例 RDS(54.29%)。所有病例均收集以下信息:胎膜早破潜伏期、出生时胎龄、脐动脉搏动指数(UA PI)、大脑中动脉搏动指数(MCA PI)、胎儿窘迫、产前使用类固醇、分娩方式、妊娠高血压疾病、妊娠期葡萄糖耐量异常或糖尿病、新生儿实验室参数、性别、体重、阿普加评分和其他新生儿并发症。采用 logistic 回归分析探讨变量对 RDS 的影响。

结果

logistic 回归分析结果显示,以下变量与 RDS 密切相关:女性(OR=0.52;95%CI:0.28-0.97)、产前使用类固醇(OR=0.46;95%CI:0.34-0.64)、UA PI 和 MCA PI 异常(OR=2.96;95%CI:1.43-6.12)(OR=2.05;95%CI:1.07-3.95)、胎儿窘迫(OR=2.33;95%CI:1.16-4.71)、产妇 HGB(OR=0.69;95%CI:0.5-0.96)和新生儿 RBC、HGB(OR=0.32;95%CI:0.19-0.55)(OR=0.75;95%CI:0.65-0.88)。

结论

早产儿 RDS 的主要危险因素是性别、胎儿胎盘循环异常和胎儿窘迫。RDS 患儿的 RBC 和 HGB 计数较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae7c/6193337/84f3a799e395/BMRI2018-7162478.001.jpg

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