Whybra Catharina, Källén Karin, Hansson Stefan R, Gunnarsson Rolf
Department of Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany.
Department of Obstetrics and Gynecology, Clinical Sciences Lund, Lund University, Lund, Sweden.
Acta Paediatr. 2020 Dec;109(12):2570-2577. doi: 10.1111/apa.15260. Epub 2020 Apr 26.
The study was designed to document the incidence of non-immune hydrops fetalis (NIHF) at birth and characterise associated outcomes and obstetric complications.
Data on more than 1.9 million births were extracted from the Swedish Birth Register for 1997-2015. Pregnancies not affected by NIHF served as controls. National registers on mortality and hospitalisations provided follow-up information.
There were 309 cases of NIHF at birth corresponding to an incidence of 1.6 per 10 000, lower than in previous studies. NIHF was more frequent in mothers aged ≥35 years and with a history of stillbirth. Preterm delivery occurred in 77.7% in the NIHF group, including 31.7% before 32 weeks of gestation. Multiple births and Caesarean sections were reported more frequent in the NIHF group. NIHF was associated with poor outcome with 14.6% stillbirths and in 26.5% early neonatal death. Overall, 58.7% of live-born children with NIHF were alive at 12 months compared with 99.7% of controls. The most common causes of death were cardiovascular diseases and thoracic abnormalities.
NIHF at birth is associated with obstetric complications and poor prognosis for the neonate related to underlying disease. The low incidence of NIHF observed in this study may reflect well-developed antenatal care.
本研究旨在记录出生时非免疫性胎儿水肿（NIHF）的发生率，并描述相关结局及产科并发症。
从瑞典1997 - 2015年出生登记册中提取了超过190万例分娩的数据。未受NIHF影响的妊娠作为对照。国家死亡率和住院登记册提供了随访信息。
出生时NIHF病例有309例，发病率为每10000例中有1.6例，低于以往研究。NIHF在年龄≥35岁且有死产史的母亲中更为常见。NIHF组早产发生率为77.7%，其中31.7%发生在妊娠32周前。NIHF组多胎分娩和剖宫产的报告更为频繁。NIHF与不良结局相关，死产率为14.6%，早期新生儿死亡率为26.5%。总体而言，NIHF活产儿中58.7%在12个月时存活，而对照组为99.7%。最常见的死亡原因是心血管疾病和胸部异常。
出生时的NIHF与产科并发症以及与潜在疾病相关的新生儿预后不良有关。本研究中观察到的NIHF低发病率可能反映了发达的产前护理。
