Wang Yuejiao, Chen Qi, Xu Shixia, Chao Shuang
Department of Pediatrics, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China.
Department of Neonatology, Shangrao Maternal and Child Healthcare Hospital of Jiangxi Province, Shangrao, China.
Front Surg. 2022 Jun 20;9:899795. doi: 10.3389/fsurg.2022.899795. eCollection 2022.
To analyze the obstetric high-risk factors and serological characteristics of early-onset neonatal bacterial infections (EONBI).
119 neonates with early-onset bacterial infection who were admitted to the neonatal ward of our hospital from October 2020 to December 2021 were recorded as the study group, and 100 neonates without bacterial infection who were admitted during the same period were used as the reference group. Comparative analysis of obstetric high-risk factors and serological characteristics of EONBI.
There was no statistical difference between the two groups in terms of gender and age at admission (> 0.05). The gestational age and birth weight of newborns in the study group were lower than those in the reference group (< 0.001). Comparing the maternal factors of EONBI between the two groups, there was no statistical difference in age, number of obstetric inspections, whether to use antibiotics, and mode of delivery (> 0.05). Univariate analysis showed that preterm birth, unexplained asphyxia, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h were significantly associated with EONBI (< 0.05); while there was no significant difference between the two groups in the comparison between diabetic mother and child and maternal fever at delivery (> 0.05). Multifactorial analysis showed that preterm birth, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h had a good multivariate dependence on EONBI (< 0.05), while there was no significant association with unexplained asphyxia, diabetic mother and child, and maternal fever at delivery (> 0.05). The incidence of neonatal temperature >37.9°C was higher in the study group than in the reference group (< 0.05), and there were no statistical differences in the comparison of other clinical manifestations (> 0.05). The CRP level of neonates in the study group (47.33 ± 4.14) mg/L was higher than that of the reference group (4.84 ± 1.03) mg/L (< 0.001). The WBC level of neonates in the study group (5.64 ± 1.18) 10/L was higher than that of the reference group (0.28 ± 0.04) 10/L (< 0.001). The PCT level of neonates in the study group (5.41 ± 0.85) µg/L was higher than that of the reference group (0.24 ± 0.07) µg/L (< 0.001).
EONBI is closely associated with several obstetric high-risk factors, including preterm birth, fecal contamination of amniotic fluid, maternal infection during pregnancy, and premature rupture of membranes ≥18 h; EONBI has no specific symptoms and signs, but serum CRP, WBC, and PCT levels are significantly higher than those of newborns without co-infection with bacteria.
分析早发型新生儿细菌感染(EONBI)的产科高危因素及血清学特征。
将2020年10月至2021年12月我院新生儿病房收治的119例早发型细菌感染新生儿记录为研究组,同期收治的100例无细菌感染新生儿作为对照组。对EONBI的产科高危因素及血清学特征进行对比分析。
两组在入院时的性别和年龄方面无统计学差异(>0.05)。研究组新生儿的胎龄和出生体重低于对照组(<0.001)。比较两组间EONBI的母亲因素,年龄、产科检查次数、是否使用抗生素及分娩方式方面无统计学差异(>0.05)。单因素分析显示,早产、不明原因窒息、羊水粪染、孕期母亲感染及胎膜早破≥18小时与EONBI显著相关(<0.05);而糖尿病母婴及分娩时母亲发热两组间比较无显著差异(>0.05)。多因素分析显示,早产、羊水粪染、孕期母亲感染及胎膜早破≥18小时对EONBI有良好的多因素依赖性(<0.05),而与不明原因窒息、糖尿病母婴及分娩时母亲发热无显著关联(>0.05)。研究组新生儿体温>37.9°C的发生率高于对照组(<0.05),其他临床表现比较无统计学差异(>0.05)。研究组新生儿的CRP水平(47.33±4.14)mg/L高于对照组(4.84±1.03)mg/L(<0.001)。研究组新生儿的WBC水平(5.64±1.18)×10⁹/L高于对照组(0.28±0.04)×10⁹/L(<0.001)。研究组新生儿的PCT水平(5.41±0.85)μg/L高于对照组(0.24±0.07)μg/L(<0.001)。
EONBI与多种产科高危因素密切相关,包括早产、羊水粪染、孕期母亲感染及胎膜早破≥18小时;EONBI无特异性症状和体征,但血清CRP、WBC及PCT水平显著高于未合并细菌感染的新生儿。