Greenough A, Yuksel B, Naik S, Cheeseman P, Nicolaides K H
Department of Child Health, King's College Hospital, London, U.K.
Eur J Pediatr. 1997 Jul;156(7):550-2. doi: 10.1007/s004310050660.
Neonatal respiratory difficulties are increased following second trimester amniocentesis. In preterm, prolonged rupture of the membranes, respiratory outcome is particularly poor when rupture occurs in the first trimester. It therefore seems likely that first trimester/ early amniocentesis (EA) would be associated with severe respiratory problems necessitating a high neonatal intensive care unit (NICU) admission rate. To test that hypothesis, the requirement for admission to the NICU of 278 infants whose mothers had undergone EA, 262 whose mothers had undergone chorion villus sampling (CVS group) and 264 controls whose mothers had undergone no invasive procedures were reviewed as were their diagnoses if they needed admission. There was no significant difference in the mode of delivery, gestational age or gender distribution of the three groups and the median maternal age of the EA and CVS groups was similar. Nineteen EA, eight CVS and five control infants required admission to the NICU (EA versus controls, P < 0.01; EA versus CVS plus controls, P < 0.005). Nine EA, one CVS and four control infants had suffered respiratory problems (EA versus CVS P < 0.05). Logistic regression analysis demonstrated that immaturity and EA were significantly associated with a requirement for NICU admission. We conclude infants whose mothers have undergone EA may be at increased risk for NICU admission, this is partly due to respiratory problems but the association is uncommon.
孕中期羊膜穿刺术后新生儿呼吸困难会增加。在早产、胎膜早破的情况下,若胎膜在孕早期破裂,呼吸结局会特别差。因此,孕早期/早期羊膜穿刺术(EA)似乎可能与严重的呼吸问题相关,这使得新生儿重症监护病房(NICU)的入院率很高。为了验证这一假设,对278名母亲接受了EA的婴儿、262名母亲接受了绒毛取样的婴儿(CVS组)以及264名母亲未接受侵入性操作的对照组婴儿的NICU入院需求进行了审查,同时审查了他们(若需要入院)的诊断情况。三组的分娩方式、胎龄或性别分布没有显著差异,EA组和CVS组的母亲年龄中位数相似。19名接受EA的婴儿、8名接受CVS的婴儿和5名对照组婴儿需要入住NICU(EA组与对照组相比,P<0.01;EA组与CVS组加对照组相比,P<0.005)。9名接受EA的婴儿、1名接受CVS的婴儿和4名对照组婴儿出现了呼吸问题(EA组与CVS组相比,P<0.05)。逻辑回归分析表明,不成熟和EA与入住NICU的需求显著相关。我们得出结论,母亲接受了EA的婴儿入住NICU的风险可能会增加,这部分是由于呼吸问题,但这种关联并不常见。