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[分娩应激与产后新生儿体重发育]

[Labor stress and postpartum neonatal weight development].

作者信息

Wenderlein J M, Ritz-Schäfer R

机构信息

Frauenklinik, Universität Ulm.

出版信息

Zentralbl Gynakol. 1994;116(2):97-101.

PMID:8147198
Abstract

55 years ago the term "stress" was defined as a general reaction pattern which, in moderation, is not only unharmful but even has a vital function. Does this also apply to intrapartal fetal stress? The results from a retrospective pilot study including 791 mature newborns without major disorders are presented to stimulate discussion and possibly give rise to prospective studies. 1. Newborns from primigravidas with labour spanning more than 12 hours incurred postpartal weight loss in excess of 5% of their birthweight only half as often as infants with shorter delivery periods. In other words, a longer expulsion phase tended to be correlated with lower postpartal weight loss in neonates. 2. As expected, the 1-minute-Apgar score was no statistically valid predictive parameter for the adaptation phase in the first 5 postpartal days of newborns. Infants with 1-minute Apgar scores of up to 6 had reached their birth-weight on the 5th postpartal day rather more often than those with better 1-minute Apgar scores. 3. In the group of mature newborns involving premature rupture of the membranes a marked gain on birthweight up to the 5th postpartal day was seen only half as often as in the group with rupture of membranes at term. 4. Weight loss of only slight proportions was seen in newborns admitted to the pediatric hospital because of suspected intra-amniotic infection half as often, compared to the other infants who also reached their birthweight faster than those with suspected intra-amniotic infection. 5. Oxytocin administered to aid labour had a positive effect on postpartal weight development.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

55年前,“应激”一词被定义为一种一般反应模式,适度的应激不仅无害,甚至还具有重要功能。这是否也适用于分娩期胎儿应激呢?本文呈现了一项回顾性初步研究的结果,该研究纳入了791名无重大疾病的足月新生儿,旨在激发讨论并可能催生前瞻性研究。1. 初产妇分娩时长超过12小时的新生儿,产后体重减轻超过出生体重5%的情况仅为分娩期较短婴儿的一半。换句话说,较长的娩出期往往与新生儿较低的产后体重减轻相关。2. 正如预期的那样,1分钟阿氏评分在新生儿产后前5天的适应阶段并非具有统计学意义的预测参数。1分钟阿氏评分高达6分的婴儿在产后第5天达到出生体重的情况比1分钟阿氏评分更好的婴儿更为常见。3. 在胎膜早破的足月新生儿组中,到产后第5天体重显著增加的情况仅为足月胎膜破裂组的一半。4. 因疑似羊膜腔内感染入住儿科医院的新生儿,体重仅有轻微减轻的情况是其他婴儿的一半,而且这些婴儿也比疑似羊膜腔内感染的婴儿更快达到出生体重。5. 用于辅助分娩的催产素对产后体重增长有积极影响。(摘要截选至250词)

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