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中华妇幼临床医学杂志(电子版) ›› 2017, Vol. 13 ›› Issue (04) : 461 -465. doi: 10.3877/cma.j.issn.1673-5250.2017.04.016

所属专题: 文献

论著

晚期早产儿中小于胎龄儿和适于胎龄儿的临床特点分析
何洋1, 蔡丽梅2, 唐军1,(), 王华1, 母得志1   
  1. 1. 610041 成都,四川大学华西第二医院儿科、出生缺陷与相关妇儿疾病教育部重点实验室
    2. 610300 成都市青白江区妇幼保健院新生儿科
  • 收稿日期:2017-05-17 修回日期:2017-07-08 出版日期:2017-08-01
  • 通信作者: 唐军

Analysis of clinical characteristics of small for gestational age infants and appropriate for gestational age infants among late preterm infants

Yang He1, Limei Cai2, Jun Tang1,(), Hua Wang1, Dezhi Mu1   

  1. 1. Department of Pediatrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
    2. Department of Neonatology, Qingbaijiang Women and Children Health Hospital of Chengdu, Chengdu 610300, Sichuan Province, China
  • Received:2017-05-17 Revised:2017-07-08 Published:2017-08-01
  • Corresponding author: Jun Tang
  • About author:
    Corresponding author: Tang Jun, Email:
引用本文:

何洋, 蔡丽梅, 唐军, 王华, 母得志. 晚期早产儿中小于胎龄儿和适于胎龄儿的临床特点分析[J]. 中华妇幼临床医学杂志(电子版), 2017, 13(04): 461-465.

Yang He, Limei Cai, Jun Tang, Hua Wang, Dezhi Mu. Analysis of clinical characteristics of small for gestational age infants and appropriate for gestational age infants among late preterm infants[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2017, 13(04): 461-465.

目的

探讨晚期早产儿中,小于胎龄(SGA)儿和适于胎龄(AGA)儿的临床特点,为提高围生期早产儿管理质量提供临床依据。

方法

选择2014年11月至2015年11月,于四川大学华西第二医院新生儿科出院的688例晚期早产儿为研究对象。按照出生胎龄与出生体重,将其中151例SGA儿纳入SGA组,537例AGA儿纳入AGA组。回顾性分析早产儿临床病例资料,统计学比较2组早产儿一般临床资料、常见并发症及其母亲孕期合并症发生情况。

结果

①SGA组早产儿出生体重较AGA组低,住院时间较AGA组长,并且差异均有统计学意义(P<0.05);2组早产儿性别构成比及娩出方式(剖宫产与自然分娩)构成比比较,差异均有统计学意义(P<0.05)。②SGA组早产儿呼吸窘迫综合征(RDS)发生率较AGA组低,消化道出血、坏死性小肠结肠炎(NEC)及低血糖发生率较AGA组高,并且差异均有统计学意义(P<0.05)。③SGA组早产儿的母亲妊娠期高血压疾病、多胎妊娠及子痫发生率较AGA组高,胎膜早破发生率,则较AGA组低,并且差异均有统计学意义(P<0.05)。④剖宫产母亲产前,使用与未使用糖皮质激素的SGA儿的RDS发生率比较,以及AGA儿的RDS发生率比较,差异均无统计学意义(P>0.05)。

结论

晚期早产儿中,SGA儿较AGA儿有更多围生期并发症,住院时间更长。需加强对晚期早产儿中SGA儿的管理及随访,提高其生存质量。

Objective

To explore the clinical characteristics of small for gestational age (SGA) infants and appropriate for gestational age (AGA) infants among late preterm infants, and to provide a clinical basis for improving the management quality of premature infants during the perinatal period.

Methods

From November 2014 to November 2015, a total of 688 late preterm infants who were discharged from Department of Neonatology, West China Second University Hospital, Sichuan University, were chosen as study subjects. According to gestational age and birth weight, 151 SGA preterm infants were included in SGA group, 537 AGA preterm infants were included in AGA group. The clinical medical records of preterm infants were analyzed retrospectively. The general clinical data, common complications and maternal pregnancy complications between two groups of preterm infants were compared statistically.

Results

①The birth weight of SGA group was lower than that of AGA group, and the duration of hospital stay was longer than that of AGA group, and the differences were statistically significant(P<0.05). There were also significant differences between two groups of preterm infants in constituent ratio of gender and delivery modes (cesarean section or eutocia) (P<0.05). ②The incidence rate of respiratory distress syndrome (RDS) of SGA group was lower than that of AGA group, while the incidence rates of alimentary tract hemorrhage, necrotizing enterocolitis (NEC) and hypoglycemia were higher than those of AGA group, and the differences were were statistically significant (P<0.05). ③The incidence rates of hypertensive disorder complicating pregnancy, multiple pregnancy and eclampsia of SGA group of maternal were higher than those of AGA group, while the incidence rate of premature rupture of fetal membranes was lower than that of AGA group, and the differences were statistically significant (P<0.05). ④For caesarean section delivery, there were no significant differences between mothers using and without using glucocorticoids before childbirth in the incidence rates of RDS for both SGA and AGA preterm infants.

Conclusions

There were more perinatal complications and longer length of stays of SGA preterm infants than AGA preterm infants. Therefore, the management and follow-up of SGA among late preterm infants should be strengthened to improve their quality of life.

表1 2组早产儿一般临床资料比较
表2 2组早产儿并发症发生率比较[例数(%)]
表3 2组早产儿的母亲孕期并发症发生情况比较[例数(%)]
表4 剖宫产母亲产前使用与未使用糖皮质激素的早产儿RDS发生率比较[例数(%)]
[1]
王长燕,李正红,王丹华. 晚期早产儿研究进展[J]. 协和医学杂志,2014, 5(4): 445-449.
[2]
殷张华,钱继红,王蓓,等. 晚期早产儿近期并发症及智能发育前瞻性研究[J]. 中国新生儿科杂志,2015, 30(2): 112-116.
[3]
Ballantyne M, Benzies KM, McDonald S, et al. Risk of developmental delay: comparison of late preterm and full term Canadian infants at age 12 months[J]. Early Hum Dev, 2016, 101: 27-32.
[4]
Narchi H, Skinner A, Williams B. Small for gestational age neonates-are we missing some by only using standard population growth standards and does it matter?[J]. J Matern Fetal Neonatal Med, 2010, 23(1): 48-54.
[5]
邵肖梅,叶鸿瑁,丘小汕. 实用新生儿学. 4版[M]. 北京:人民卫生出版社,2011: 46, 396-397, 402-403, 424-425, 479-480.
[6]
谢幸,苟文丽. 妇产科学. 8版[M]. 北京:人民卫生出版社,2013: 67, 74, 77, 133-134.
[7]
Gill JV, Boyle EM. Outcomes of infants born near term[J]. Arch Dis Child, 2017, 102(2): 194-198.
[8]
Trembath AN, Payne A, Colaizy TT, et al. The problems of moderate preterm infants[J]. Semin Perinatol, 2016, 40(6): 370-373.
[9]
王红宇,候莹,刁敬军. 晚期早产儿中小于胎龄儿的临床回顾分析[J]. 中国儿童保健杂志,2014, 22(1): 86-88.
[10]
鲁利群,屈艺,母得志. 晚期早产儿研究进展[J]. 中华实用儿科临床杂志,2011, 26(20): 1605-1608.
[11]
高琦,郑军,田秀英,等. 极低出生体重儿适于胎龄儿与小于胎龄儿危险因素及并发症的比较[J]. 中国妇幼保健,2013, 28(9): 1449-1451.
[12]
宁岩. 地塞米松预防晚期早产儿及足月儿呼吸窘迫综合征的疗效观察[D]. 长春:吉林大学,2013: 30-33.
[13]
胡培艳. 早产孕妇产前应用激素的对比研究[J]. 中国医学创新,2014, 11(8): 155-156.
[14]
陈学才,王乐红. 近足月小于胎龄儿与适于胎龄儿并发坏死性小肠结肠炎的预后对比研究[J]. 江西医药,2016, 51(2): 173-175.
[15]
吴玫瑰,黄志坚,李坚,等. 早产儿低血糖与胎龄、体重、脑损伤关系的分析[J]. 广州医药,2014, 45(1): 50-52.
[16]
裴新,赵巧红,蒋俊燕. 不同分娩方式新生儿低血糖发生情况分析与护理[J].  护理学报,2010, 17(5A): 56-57.
[17]
Adamkin DH. Neonatal hypoglycemia[J]. Semin Fetal Neonatal Med, 2016, 22(1): 36-41.
[18]
Adamkin DH. Neonatal hypoglycemia[J]. Curr Opin Pediatr, 2016, 28(2): 150-155.
[19]
陆春梅. 晚期早产儿中小于胎龄儿的临床及危险因素分析[J]. 中国妇幼健康研究,2016, 27(S2): 311.
[20]
叶素芬. 晚期早产儿中小于胎龄儿的临床特点分析[J]. 现代诊断与治疗,2015, 26(14): 3264-3265.
[21]
邢秋景,高亮,程慧清,等. 晚期早产儿与早期足月儿剖宫产分娩高危因素及预后分析[J]. 中国妇幼保健,2015, 30(36): 6479-6482.
[22]
辛玥,郑荣秀,刘丹. 晚期早产儿中小于胎龄儿的临床特点及生长情况研究[J]. 中国全科医学,2016, 19(19): 2288-2293.
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