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2023年7月 第38卷 第7期11
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早产胎膜早破合并孕妇肥胖对≥34周早产儿住院结局的影响

The influence of preterm premature rupture of membranes and pregnant women obesity on hospitalization outcome of 34 weeks or over preterm infants

来源期刊: 广州医药 | 57-61 发布时间:2023-04-14 收稿时间:2025/11/13 18:37:16 阅读量:23
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关键词:
早产胎膜早破肥胖晚期早产儿住院结局
preterm premature rupture of membraneobesitylate preterm infantshospitalization outcome
DOI:
10.3969/j.issn.1000-8535.2023.03.011
收稿时间:
2022-03-10 
修订日期:
 
接收日期:
 
引用总数:
1  
目的 比较早产胎膜早破(PPROM)≥34周的肥胖孕妇与非肥胖孕妇的早产儿住院结局。方法 回顾性分析2016年1月—2020年12月在本院出生并入住新生儿科的所有出生胎龄≥34周的PPROM早产儿。根据孕妇分娩时体质量指数(BMI),分为肥胖组(BMI≥30 kg/m2)和非肥胖组(BMI<30 kg/m2),比较2组间的一般情况、妊娠结局及所生晚期早产儿的住院结局,组间比较采用两独立样本t检验及χ2检验。结果 与非肥胖孕妇相比,肥胖孕妇的晚期早产儿分娩后呼吸道并发症发病率高,主要表现为新生儿呼吸窘迫综合征,辅助通气、吸氧和表面活性物质的使用、败血症、感染性肺炎发病率高,母亲妊娠期糖尿病发病率增高,差异均具有统计学意义(P<0.05),其余新生儿高胆红素血症、新生儿坏死性小肠结肠炎、脑室内出血、早产儿支气管肺发育不良等并发症比较无统计学意义(P>0.05)。结论 PPROM≥34周的肥胖孕妇与非肥胖孕妇相比,所生晚期早产儿呼吸道并发症和败血症等不良结局的发生率增加。
Objective To compare the hospitalization outcomes of 34 weeks or over preterm infants with preterm premature rupture of membranes (PPROM) in obese and non-obese pregnant women. Methods A retrospective analysis of PPROM preterm infants born in our hospital and admitted to the neonatology department from January 2016 to December 2020 with a gestational age of 34 weeks or over was carried out. According to the pregnant women's body mass index (BMI) at delivery, they were divided into obese group (BMI≥30 kg/m2) and non-obese group (BMI<30 kg/m2). The general conditions, pregnancy outcomes and late premature infants hospitalization outcomes between the two groups were compared using two independent samples t test and χ2 test. Results Compared with non-obese pregnant women, the incidence of respiratory complications after delivery in late preterm infants of obese pregnant women was higher, mainly manifested as high incidence of neonatal respiratory distress syndrome, assisted ventilation, oxygen inhalation and the use of surfactants, sepsis, and pneumonia, also maternal gestational diabetes incidence was increased, and the differences were statistically significant (P<0.05); other complications of neonatal hyperbilirubinemia, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia were not statistically significant (P>0.05). Conclusions Compared with non-obese pregnant women with 34 weeks or over PPROM, obese pregnant women had an increased incidence of adverse outcomes in late preterm infants such as respiratory complications and sepsis.
1、 赵欣,杨慧霞.超重/肥胖女性孕期增重过多对妊娠结局及子代远期健康影响的研究进展[J].中华围产医学杂志,2020,23(9):640-644. 赵欣,杨慧霞.超重/肥胖女性孕期增重过多对妊娠结局及子代远期健康影响的研究进展[J].中华围产医学杂志,2020,23(9):640-644.
2、 SCHMATZ M, MADAN J, MARINO T, et al. Maternal obesity: the interplay between inflammation, mother and fetus[J].J Perinatol, 2010, 30(7): 441-446. SCHMATZ M, MADAN J, MARINO T, et al. Maternal obesity: the interplay between inflammation, mother and fetus[J].J Perinatol, 2010, 30(7): 441-446.
3、 TEO J D, MORRIS M J, JONES N M.Maternal obesity increases inflammation and exacerbates damage following neonatal hypoxic-ischaemic brain injury in rats[J].Brain Behav Immun, 2017(63): 186-196. TEO J D, MORRIS M J, JONES N M.Maternal obesity increases inflammation and exacerbates damage following neonatal hypoxic-ischaemic brain injury in rats[J].Brain Behav Immun, 2017(63): 186-196.
4、 JARVIE E, HAUGUEL-de-MOUZON S, NELSON S M, et al. Lipotoxicity in obese pregnancy and its potential role in adverse pregnancy outcome and obesity in the offspring[J].Clin Sci (Lond), 2010, 119(3): 123-129. JARVIE E, HAUGUEL-de-MOUZON S, NELSON S M, et al. Lipotoxicity in obese pregnancy and its potential role in adverse pregnancy outcome and obesity in the offspring[J].Clin Sci (Lond), 2010, 119(3): 123-129.
5、 POLNASZEK B E, RAGHURAMAN N, LOPEZ J D, et al.Neonatal morbidity in the offspring of obese women without hypertension or diabetes[J].Obstet Gynecol, 2018, 132(4): 835-841. POLNASZEK B E, RAGHURAMAN N, LOPEZ J D, et al.Neonatal morbidity in the offspring of obese women without hypertension or diabetes[J].Obstet Gynecol, 2018, 132(4): 835-841.
6、 CRANE J M, MURPHY P, BURRAGE L,et al.Maternal and perinatal outcomes of extreme obesity in pregnancy[J].J Obstet Gynaecol Can, 2013, 35(7): 606-611. CRANE J M, MURPHY P, BURRAGE L,et al.Maternal and perinatal outcomes of extreme obesity in pregnancy[J].J Obstet Gynaecol Can, 2013, 35(7): 606-611.
7、 FAUCETT A M, METZ T D, DEWITT P E, et al. Effect of obesity on neonatal outcomes in pregnancies with preterm premature rupture of membranes[J].Am J Obstet Gynecol, 2016, 214(2): 287.e1-287.e5. FAUCETT A M, METZ T D, DEWITT P E, et al. Effect of obesity on neonatal outcomes in pregnancies with preterm premature rupture of membranes[J].Am J Obstet Gynecol, 2016, 214(2): 287.e1-287.e5.
8、 GYAMFI-BANNERMAN C,THORN E A,BLACKWELL S C,et a1.Antenatal betamethasone for women at risk for late preterm delivery[J].N Engl J Med,2016,374(14):1311-1320. GYAMFI-BANNERMAN C,THORN E A,BLACKWELL S C,et a1.Antenatal betamethasone for women at risk for late preterm delivery[J].N Engl J Med,2016,374(14):1311-1320.
9、 SWEET D G, CARNIELLI V, GREISEN G, et al.European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2019 Update[J].Neonatology,2019,115(4):432-450. SWEET D G, CARNIELLI V, GREISEN G, et al.European Consensus Guidelines on the Management of Respiratory Distress Syndrome-2019 Update[J].Neonatology,2019,115(4):432-450.
10、 余丽燕,卓泽勇,胡小玲.妊娠期糖尿病对早产儿呼吸窘迫综合征发生率的影响[J].中国实用医药,2020,15(29):98-100. 余丽燕,卓泽勇,胡小玲.妊娠期糖尿病对早产儿呼吸窘迫综合征发生率的影响[J].中国实用医药,2020,15(29):98-100.
11、 杨雪,赵旭晶.不同胎龄新生儿呼吸窘迫综合征的临床特征及相关危险因素分析[J].中国妇幼保健,2017,32(17):4157-4160. 杨雪,赵旭晶.不同胎龄新生儿呼吸窘迫综合征的临床特征及相关危险因素分析[J].中国妇幼保健,2017,32(17):4157-4160.
12、 李铁建.病态肥胖产妇孕期并发症以及剖宫产麻醉并发症临床分析[J].中国临床医生杂志,2019,47(4):481-482. 李铁建.病态肥胖产妇孕期并发症以及剖宫产麻醉并发症临床分析[J].中国临床医生杂志,2019,47(4):481-482.
13、 KIM T, BURN S C, BANGDIWALA A, et al. Neonatal morbidity and maternal complication rates in women with a delivery body mass index of 60 or higher[J].Obstet Gynecol, 2017, 130(5): 988-993. KIM T, BURN S C, BANGDIWALA A, et al. Neonatal morbidity and maternal complication rates in women with a delivery body mass index of 60 or higher[J].Obstet Gynecol, 2017, 130(5): 988-993.
14、 LOCK M C, MCGILLICK E V, ORGEIG S, et al.Differential effects of late gestation maternal overnutrition on the regulation of surfactant maturation in fetal and postnatal life[J].J Physiol, 2017, 595(21): 6635-6652. LOCK M C, MCGILLICK E V, ORGEIG S, et al.Differential effects of late gestation maternal overnutrition on the regulation of surfactant maturation in fetal and postnatal life[J].J Physiol, 2017, 595(21): 6635-6652.
15、 张素娥,陈雪雨,陈春,等.胎膜早破对超早产儿早期预后的影响[J].中国当代儿科杂志,2021,23(1):25-30. 张素娥,陈雪雨,陈春,等.胎膜早破对超早产儿早期预后的影响[J].中国当代儿科杂志,2021,23(1):25-30.
16、 Obesity: preventing and managing the global epidemic.Report of a WHO consultation[J].World Health Organ Tech Rep Ser, 2000(894): i-xii, 1-253. Obesity: preventing and managing the global epidemic.Report of a WHO consultation[J].World Health Organ Tech Rep Ser, 2000(894): i-xii, 1-253.
17、 中华医学会儿科学分会新生儿学组,中国医师协会新生儿科医师分会感染专业委员会.新生儿败血症诊断及治疗专家共识(2019年版)[J].中华儿科杂志,2019,57(4):252-257. 中华医学会儿科学分会新生儿学组,中国医师协会新生儿科医师分会感染专业委员会.新生儿败血症诊断及治疗专家共识(2019年版)[J].中华儿科杂志,2019,57(4):252-257.
18、 PAPILE L, BURSTEIN J, BURSTEIN R,et al.Incidence and evolution of subependymal and intraventricular hemorrhage; a study of infants with birth weights less than 1500gm[J].J Pediatr,1978,92(4):529-534. PAPILE L, BURSTEIN J, BURSTEIN R,et al.Incidence and evolution of subependymal and intraventricular hemorrhage; a study of infants with birth weights less than 1500gm[J].J Pediatr,1978,92(4):529-534.
19、 SMID M C, VLADUTIU C J, DOTTERS-KATZ S K, et al.Maternal super obesity and neonatal morbidity after term cesarean delivery[J].Am J Perinatol, 2016, 33(12): 1198-1204. SMID M C, VLADUTIU C J, DOTTERS-KATZ S K, et al.Maternal super obesity and neonatal morbidity after term cesarean delivery[J].Am J Perinatol, 2016, 33(12): 1198-1204.
20、 FINKELSTEIN E A, KHAVJOU O A, THOMPSON H, et al. Obesity and severe obesity forecasts through 2030[J].Am J Prev Med, 2012, 42(6): 563-570. FINKELSTEIN E A, KHAVJOU O A, THOMPSON H, et al. Obesity and severe obesity forecasts through 2030[J].Am J Prev Med, 2012, 42(6): 563-570.
21、 AUNE D, SAUGSTAD O D, HENRIKSEN T, et al.Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis[J].JAMA, 2014, 311(15): 1536-1546. AUNE D, SAUGSTAD O D, HENRIKSEN T, et al.Maternal body mass index and the risk of fetal death, stillbirth, and infant death: a systematic review and meta-analysis[J].JAMA, 2014, 311(15): 1536-1546.
22、 LI N, LIU E, GUO J, et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes[J].PLoS One, 2013, 8(12): e82310. LI N, LIU E, GUO J, et al. Maternal prepregnancy body mass index and gestational weight gain on pregnancy outcomes[J].PLoS One, 2013, 8(12): e82310.
23、 MORRIS J M, ROBERTS C L, BOWEN J R, et al.Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial[J].Lancet, 2016, 387(10017): 444-452. MORRIS J M, ROBERTS C L, BOWEN J R, et al.Immediate delivery compared with expectant management after preterm pre-labour rupture of the membranes close to term (PPROMT trial): a randomised controlled trial[J].Lancet, 2016, 387(10017): 444-452.
24、 吴甜,石晶,鲍珊,等.胎膜早破对孕母感染及早产儿结局的影响[J].中国当代儿科杂志,2017,19(8):861-865. 吴甜,石晶,鲍珊,等.胎膜早破对孕母感染及早产儿结局的影响[J].中国当代儿科杂志,2017,19(8):861-865.
25、 BOND D M, MIDDLETON P, LEVETT K M, et al.Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome[J].Cochrane Database Syst Rev, 2017, 3(3): CD004735. BOND D M, MIDDLETON P, LEVETT K M, et al.Planned early birth versus expectant management for women with preterm prelabour rupture of membranes prior to 37 weeks' gestation for improving pregnancy outcome[J].Cochrane Database Syst Rev, 2017, 3(3): CD004735.
26、 中华医学会妇产科学分会产科学组.胎膜早破的诊断与处理指南(2015)[J].中华妇产科杂志,2015,50(1):3-8. 中华医学会妇产科学分会产科学组.胎膜早破的诊断与处理指南(2015)[J].中华妇产科杂志,2015,50(1):3-8.
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