新生儿1分钟Apgar评分及其影响因素  

Clinical-epidemiological study on newborn's Apgar score in‘one minute’and relevant factors

作　　者：张秀军[1] 李茉 张泽坤[1] 胡耕励[3] 束宝莲 方光辉[3] 孙业桓[1] 倪进发[1] 

机构地区：[1]安徽医科大学流行病学与卫生统计学系,合肥230032 [2]解放军第一○五医院妇产科 [3]合肥市妇婴保健院

出　　处：《中华流行病学杂志》2007年第8期794-797,共4页Chinese Journal of Epidemiology

基　　金：安徽省2006年度重点资助项目(060230060)

摘　　要：目的探讨新生儿1分钟Apgar评分及其相关影响因素。方法以安徽省某市级妇婴保健院一年间住院分娩的产妇作为研究对象,使用Apgar评分法对新生儿进行评分,采用自编调查表进行问卷调查。结果Apgar评分为1分钟8～10分者1875人(73.78%)。4～7分426人(16.77%),0～3分240人(9.45%)。Apgar评分1分钟和5分钟评分平均分别为7.69分±2.27分、9.01分±1.89分,二者呈高度相关(Pearson相关系数r=0.841,P<0.001);多因素有序结果的累积比数logistic回归分析显示:产妇年龄(OR=1.04)、产妇职业为农民(OR=2.22)、产次(OR=1.26)、阴道助产(OR:4.93)、剖宫产(OR=1.95)、妊娠高血压综合征(OR=1.42)、妊娠期蛋白尿(OR=1.44)、新生儿性别男性(OR=1.23)、新生儿体重<2500g(低体重,LBW)(OR=2.94)、新生儿先天畸形(OR=12.12)、孕周<37周(早产)(OR=1.22)、分娩时并发症(OR=5.04)为危险因素;而产妇学历年限(OR=0.91)、有产前检查(OR=0.48)、新生儿身长(OR:0.88)、单胎(OR=0.57)为保护因素。结论新生儿1分钟Apgar评分受多种因素影响,应加强社区产妇早期保健,早期发现和控制孕期高危因素。Objective To study the newborn＇s Apgar score in ‘one minute＇ and relevant factors. Methods One year inpatient woman from a Maternal and Child Health Hospital of Anhui province were selected by cluster sampling method and newborn asphyxia situation was investigated using Apgar score and self designed questionnaire. Results The Apgar score in ‘one minute＇ which marking 8 to 10, 4 to 7 and 0 to 3 were found in 1875 （73.78 % ）, 426（ 16.77 % ） and 240 infants（9.45 % ） respectively. The average Apgar score in ＇one minute＇ and five minutes were （7.69± 2.27） and （9.01 ± 1.89） respectively, The Apgar score in ‘one minute＇ was significantly correlated with that of five minutes （Pearson coefficient correlation r = 0.841, P= 0.00）. Ordinal regression analysis revealed that parturient age（ OR = 1.04）, being farmer （ OR = 2.22）, parity（ OR = 1.26）, assistant vaginal delivery（ OR = 4.93）, caesarean section （ OR = 1.95 ）, pregnancy-induced hypertension syndrome （ OR = 1.42）, albuminuria in gestational period （ OR = 1.44）, newborn being male （ OR = 1.23 ）, low birth weight （ OR = 2.94 ）, inborn abnormality （ OR = 12.12）, premature birth （ OR = 1.22） and complications of delivery（ OR - 5.04） were risk factors while the number of years under study（ OR = 0.91 ）, prenatal check-up （OR = 0.48）, body length of newborn infant（ OR = 0.88） and single birth （ OR = 0.57） were protective factors. Conclusion Apgar score in‘one minute＇ of newborn infant was affected by several factors as stated above. Health care program in earlier period toward community parturient should be strengthened in order to discover and control high risk factors of duration of pregnancy in earlier period.

关 键 词：新生儿 APGAR评分 妇产科 临床流行病学 

分 类 号：R722.1[医药卫生—儿科]