【目的】 分析小于胎龄儿(small-for-gestational-age infants,SGA)的出生、健康状况、并发症发生、死亡及其影响因素,以期为产科、儿科、儿保等科学护理SGA提供临床依据。 【方法】 回顾性分析2006年1月1日-2007年12月31日在北京市海淀区妇幼保健院出生的全部新生儿资料,选择其中的217例SGA为病例组,每月1日出生的240例适于胎龄儿儿(appropriate gestational age infants,AGA)为对照组。详细分析两组并发症发生情况及母亲孕期感染、妊高症、糖尿病、贫血、胎膜早破、羊水异常、脐带异常、双胎等情况。 【结果】 2006-2007年北京市海淀区妇幼保健院共分娩新生儿22 752名,其中SGA儿217例,SGA出生率为0.95%;SGA并发症发生率依次为高胆红素血症(31.3%)、呼吸系统并发症(10.6%)、贫血(5.5%)、低血糖(5.1%)、消化系统并发症(4.6%),SGA并发症发生率高于AGA,差异有统计学意义(P＜0.05);母亲妊高症、脐带异常、胎膜早破、双胎妊娠是导致SGA的主要因素;小于胎龄儿死亡率为1.4%,明显高于AGA死亡率(0.14%)及新生儿总死亡率(0.15%),差异有统计学意义(P＜0.05)。 【结论】 SGA发生与母亲妊高症等因素有关,SGA容易发生并发症,死亡率高,应该加强预防和科学护理。
Abstract
【Objective】 To study the birth rate,health,complications,mortality of small for gestational age (SGA) infants and influencing factors,so as to provide evidence for caring SGA infants in the department of obstetrics,pediatrics and child healthcare. 【Methods】 Data of all newborns born in Beijing Haidian Maternal and Child Health Hospital were collected for statistical analyses from January 1,2006 to December 31,2007.The 217 SGA infants were selected as the case group.The appropriate for gestational age (AGA) infants who were born on the first day of every month were randomly selected as the comparison group.The complications and maternal infections,pregnancy-induced hypertension,diabetes,anemia,premature placenta,etc.were analyzed. 【Results】 In the 22 752 infants born from 2006 to 2007,217 infants were SGA.The birth rate of SGA infants was 0.95%.The incidence rate of complications of SGA infants from high to low were:hyperbilirubinemia (31.3%),respiratory diseases (10.6%),anemia (5.5%),hypoglycemia (5.1%),digestive diseases (4.6%).The SGA infants had significantly higher incidence rate of complications than those AGA infants (P＜0.05).Pregnancy-induced hypertension,abnormality of umbilical cord,premature rupture of membranes and twin were the major factors associated with SGA.The mortality of SGA was 1.4%,higher than that of AGA (0.14%) and total newborn mortality (0.15%),with statistically significant difference(P＜0.05). 【Conclusion】 The factors such as pregnancy-induced hypertension was the major factor associated with SGA.SGA had higher incidence rate of complications and mortality,who should be paid attention in further prevention and scientific care.
关键词
小于胎龄儿 /
出生率 /
婴儿死亡率 /
婴儿
Key words
small for gestational age /
birth rate /
mortality /
infant
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参考文献
[1] 王庆红.我国SGA现状分析[J].中国实用儿科杂志,2009,24(1):3-5.
[2] Chen HY,Chauhan SP,Ward TCS,et al.Aberrant fetal growth and early,late,and postneonatal mortality:an analysis of Milwaukee births,1996-2007[J].Am J Obstet Gynecol,2011,192:352-353.
[3] Pennell CE,Jacobsson B,Williams SM,et al.Genetic epideminological studies of preterm birth:Guideline for research[J].Am J ObetetGynecol,2007,196(2):107-108.
[4] 金汉珍,黄德珉,官希吉.实用新生儿学[M].3版.北京:人民出版社,2003:23-50.
[5] 胡亚美,江载芳.实用儿科学[M].7版.北京:人民出版社,2002:33-60.
[6] 陈超,魏克伦,姚裕家,等.早产儿管理指南[J].中华儿科杂志,2006,44(2):188-191.
[7] Sundquist J,Sundquist K,Johansson SE.Mothers,places and small for gestational age births:a cohort study[J].Arch Dis Child,2010,20(11):111-113.
[8] Ray JG,Jiang D,Sgro M.Thresholds for small for gestational age among newborns of East Asian and South Asian ancestry[J].J Obstet Gynaecol Can,2009,31(4):322-330.
[9] 李秋平,封志纯.美国儿科学会最新新生儿黄疸诊疗指南[J].实用儿科临床杂志,2006,21(14):958-960.
[10] Newman TB,Xiong B,Gonzales VM,et al,Prediction and prevention of extreme neonatal hyperbilirubinemia in a mature health maintenance organization[J].Arch Pediatr Adolesc Med,2000,154(11):1140-1147.
[11] Voigt M,Briese V.The influence of smoking during pregnancy on fetal growth.Considering daily cigarette consumption and the SGA rate according to length of gestation[J].Z Geburtshilfe Neonatol,2009,213(5):194-200.
[12] Mclntire DD,Blom SL,Casey BM,et al.Birth weight in relation to mobility and mortality among new born infants[J].N Engl J Med,1999,340:1234-1238.
[13] 彭咏梅,冯玲英,郭志开,等.203例低出生体重儿智能发育16年纵向随访监测[J].中国儿童保健杂志,2003,11(1):1-3.
[14] Fattal-Valevski A,Leitner Y,Kutai M,et al.Neurodevelop-mental outcome in children with intrauterine growth retardation:a 3-year follow up[J].J Child Neurol,1999,14:724-727.
[15] 李松,洪世欣,王太福,等.早产和低出生体重及SGA与脑性瘫痪发病的关系[J].中华儿科杂志,2003,41(5):344-347.
[16] 叶飘,皮光环,刘敬涛,等.早产儿、足月SGA与听力损失关系的探讨[ J].中国儿童保健杂志,2005,13(2):111-113.
[17] Escobar GJ,Clark RH,Hulac P,et al.Rehospitalisation after birth hospitalization:patterns among infants of all gestations[J].Arch Dis Child,2005,90:125-131.
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