通讯作者: 田昌军, tcjun8183@163.com

DOI：10.12201/bmr.202502.00007

Risk factors and clinical outcome of meconium-stained amniotic fluid in preterm infants

• 摘要：目的 探究分析早产儿羊水胎粪污染(meconium-stained amniotic fluid,MSAF)的危险因素及早产儿临床结局、预后。方法　以2022年1月至2023年12月在我院分娩胎龄<37周的早产儿为研究对象,根据有无羊水胎粪污染进行分组,有羊水胎粪污染者31例为MSAF组,选取同期住院无羊水胎粪污染的早产儿按1:1比例随机配对选取胎龄-体重相匹配的31例早产儿为非MSAF组。回顾性收集分析两组早产儿母亲孕期及围产期情况,比较两组患儿相关因素的差异；Logistic回归分析早产儿MSAF的相关危险因素；比较两组早产儿并发症情况及临床结局。结果 研究期间总共收集胎龄<37周的早产儿387例,其中合并MSAF的早产儿 31例,早产儿MSAF发生率8.0%。MSAF组高龄产妇、胎膜早破＞18小时、产前发热、孕期胆汁淤积发生率高于非MSAF组。Logistic回归分析提示妊娠期合并胆汁淤积症、生后6h内WBC计数≥30×109/L增加早产儿MSAF发生率。两组早产儿生后脐动脉血气分析结果差异无统计学意义。MSAF组生后6小时内白细胞计数≥30×109/L、超敏C反应蛋白＞0.8mg/L、白介素6＞6pg/L比例高于非MSAF组。MSAF组新生儿宫内感染性肺炎、喂养不耐受、新生儿坏死性小肠结肠炎发生率高于非MSAF组。结论 高龄产妇、宫内感染、妊娠期合并肝内胆汁淤积可能是早产儿MSAF的主要危险因素。MSAF早产儿宫内感染性肺炎、喂养不耐受及新生儿坏死性小肠结肠炎发病率更高,且住院时间更长。

  关键词： 早产儿; 羊水胎粪污染; 危险因素; 并发症

   

  Abstract: Objective To investigate and analyze the risk factors for meconium-stained amniotic fluid(MSAF) in preterm infants and the clinical outcome and prognosis of preterm infants. Methods Preterm infants with gestational age <37 weeks delivered in our hospital from January 2022 to December 2023 were used as the study subjects, and they were grouped according to the presence or absence of meconium-stained amniotic fluid; 31 cases with meconium-stained amniotic fluid were in the MSAF group, and 31 cases of preterm infants hospitalized during the same period without meconium-stained amniotic fluid were randomly paired in the ratio of 1:1 to select 31 cases of preterm infants with gestational age-weight matching as the non-MSAF group. Retrospective collection and analysis of pregnancy and perinatal conditions of mothers of preterm infants in the two groups, comparing the differences of related factors between the two groups of children; Logistic regression analysis of risk factors related to MSAF in preterm infants; comparing the complications and clinical outcomes of preterm infants in the two groups. Results A total of 387 preterm infants with gestational age <37 weeks were collected during the study period, including 31 preterm infants with comorbid MSAF, and the prevalence of MSAF in preterm infants was 8.0%. The MSAF group had a higher incidence of advanced maternal age, premature rupture of membranes >18 hours, antepartum fever, and cholestasis during pregnancy than the non-MSAF group. Logistic regression analysis suggested that combined cholestasis during pregnancy and WBC count ≥30×109/L within 6 h after birth increased the incidence of MSAF in preterm infants. There was no statistically significant difference in the results of postnatal umbilical artery blood gas analysis between the two groups of preterm infants. The proportion of leukocyte count ≥30×10E9/L, ultrasensitive C-reactive protein >0.8 mg/L, and interleukin 6 >6 pg/L in the MSAF group was higher than that of the non-MSAF group in the 6 hours after birth. The MSAF group had a higher incidence of intrauterine infectious pneumonia, feeding intolerance, and necrotizing small bowel colitis in neonates than the non-MSAF group. Conclusions Advanced maternal age, intrauterine infections, and combined intrahepatic cholestasis during pregnancy may be the major risk factors for MSAF in preterm infants.MSAF preterm infants have a higher prevalence of intrauterine infectious pneumonitis, feeding intolerance, and necrotizing small bowel colitis in newborns, as well as longer hospital stays.

  Key words: Preterm infants; Meconium-stained amniotic fluid; Risk factors; Complications

  提交时间：2025-02-08

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• 序号	提交日期	编号	操作
  1	2024-11-08	bmr.202502.00007V1	下载

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