目的 研究与高龄产妇新生儿缺氧缺血性脑病(HIE)发生相关危险因素以及防治策略。方法 2010年1月-2016年6月期间选取128例住院分娩的高龄产妇作为研究对象,根据新生儿是否被诊断为缺氧缺血性脑病分为两组:HIE组:住院期间被诊断为HIE的患者(n=66);对照组:与HIE组同期出生正常的新生儿(n=62)。回顾性收集研究对象相关临床资料,并进行单因素和多因素Logistic回归分析。结果 1)单因素分析结果:HIE病例组妊娠期贫血(χ²=13.84)、妊娠期糖尿病(χ²=21.27)、妊高症(χ²=3.98)、胎盘早剥(χ²=4.43)、脐带缠绕(χ²=3.70)、宫内感染(χ²=9.16)和羊水污染(χ²=8.27)的比例均显著高于对照组患者(P<0.05或<0.01)。2)Logistic回归分析结果:妊娠期贫血(OR=8.24)、妊娠期糖尿病(OR=11.14)、妊高症(OR=6.78)、胎盘早剥(OR=6.94)、脐带缠绕(OR=6.51)和羊水污染(OR=3.11)是HIE发生的独立危险因素(P<0.05或<0.01)。结论 妊娠期贫血、妊娠期糖尿病、妊高症等孕期并发症以及胎盘早剥、脐带缠绕和羊水污染会增HIE的发生风险;对HIE新生儿应该采取综合的防治措施以降低HIE的发生率。

Objective To explore risk factors associate with hypoxic-schemic encephalopathy (HIE) and preventive strategies among neonates of elderly parturient women. Methods From January 2010 to June 2016,a total of 128 case of elderly parturient women were selected.A total of 66 neonates who were diagnosed as HIE were placed into HIE group,while a total of 62 neonates without HIE were divided into control group.Risk factors associated with HIE were collected and analyzed by one way analysis and multiple Logistic regression analysis. Results 1) One way analysis showed that the prevalence of gestational anemia (χ²=13.84),gestational diabetes mellitus (χ²=21.27),hypertensive disorder complicating pregnancy (χ²=3.98),placental abruption (χ²=4.43),cord entanglement (χ²=3.70),intrauterine infection (χ²=9.16) and amniotic fluid contamination (χ²=8.27) in HIE group were significantly greater than those in control group(P<0.05 or <0.01).2) Logistic regression analysis showed gestational anemia (OR=8.24),gestational diabetes mellitus (OR=11.14),hypertensive disorder complicating pregnanc (OR=6.78),placental abruption (OR=6.94),cord entanglement (OR=6.51) and amniotic fluid contamination (OR=3.11) were independent HIE risk factors(P<0.05 or <0.01). Conclusions Gestational anemia,gestational diabetes mellitus,hypertensive disorder complicating pregnanc,placental abruption,cord entanglement and amniotic fluid contamination can increase the risk of HIE.Comprehensive preventive nursing strategies and therapy need to be taken in order to reduce the risk of HIE.