低出生体质量儿适宜的分娩方式及适时终止妊娠时机的选择  

Appropriate delivery mode and timing of termination for pregnancy with low birth weight infants

作　　者：陈奕[1] 邹丽颖[1] 李光辉[1] 阮炎[1] 王欣[1] 张为远[1] 

机构地区：[1]首都医科大学附属北京妇产医院产科,100026

出　　处：《中华妇产科杂志》2015年第5期323-328,共6页Chinese Journal of Obstetrics and Gynecology

基　　金：卫生公益性行业科研专项（201002013）;北京市卫生局高层次人才基金（2009-2-11）

摘　　要：目的：调查分析我国低出生体质量儿的分娩方式及围产结局，探讨其适宜的分娩方式及适时终止妊娠的时机。方法对2011年1月1日至12月31日我国东北、西北、华北、华中、华东、华南、西南地区，包括首都医科大学附属北京妇产医院在内的39家医院分娩的103678例孕产妇的有效临床资料进行回顾性分析。结果（1）新生儿平均出生体质量为（3263±540）g，低出生体重儿7474例，发生率为7.209％（7474/103678）。其中足月低出生体质量儿2214例，发生率为2.328%（2214/95116）；早产低出生体质量儿5260例，发生率为61.434%（5260/8562例）。（2）自28孕周起至36孕周，剖宫产率随孕周的增加而上升。足月低出生体质量儿的剖宫产率为61.14％（1139/1863），高于出生正常体质量儿的52.947％（45108/85195），两者比较，差异有统计学意义（P〈0.01）。（3）低出生体质量儿的剖宫产指征构成比显示，10.73％（443/4128）为社会因素，48.91％（2019/4128）为母体因素；出生正常体质量儿的剖宫产指征构成比的社会因素、母体因素分别为27.70％（12495/45108）、38.60％（17412/45108）。两者比较，差异均有统计学意义（P〈0.01）。（4）足月低出生体质量儿的急诊剖宫产率为41.09%（468/1139），比出生正常体质量儿急诊剖宫产率的31.09%（14024/45108）明显上升，差异有统计学意义（P〈0.01）。（5）足月低出生体质量儿的死产率、新生儿窒息率及新生儿死亡率分别为2.36％（44/1863）、6.12％（114/1863）和3.17％（59/1863）；出生正常体质量儿则分别为0.11％（94/85195）、1.41％（1201/85195）和0.14％（119/85195）；分别比较，差异均有统计学意义（P〈0.01）。（6）以剖宫产术分娩的低出生体质量儿死产率（0.53%）及新生儿死亡率（0.97%）明显低于阴道分娩者（分别为5.25%、6.63%）；尤其是在孕28～33周＋6的剖宫�Objectives To investigate the delivery mode and perinatal outcomes of low birth weight infants in China's Mainland, and to explore the appropriate delivery mode and timing of delivery. Methods Clinical data of 103 678 babies delivered from Jan 1st to Dec 31th, 2011 in 39 hospitals in China's Mainland were analyzed retrospectively. The 39 hospitals located in 7 administrative regions, including Northeast, Northwest, North, Central, East, South and Southwest China. Result （1） The average birth weight of the newborns was （3 263 ± 540） g. Among them, 7 474 cases were diagnosed low birth weight infants, with the＆amp;nbsp;incidence of 7.209%（7 474/103 678）. There were 2.328%（2 214/95 116 ） full-term low birth weight infants and 61.434% （5 260/8 562 ） preterm low birth weight infants. （2） From week 28 to week 36, the cesarean section rate of low birth weight infants increased with the increasing of gestational weeks. The cesarean section rate of full-term low birth weight infants were 61.14%（1 139/1 863） , which was higher than that of normal birth weight infants （52.947%, 45 108/85 195）. The differences were statistically significant （P〈0.01）. （3） The constitution of the indication of cesarean section showed that social factor and maternal factor were 10.73%（443/4 128） and 48.91%（2 019/4 128） for low birth weight infants, respectively. While for the normal birth weight infants, they were 27.70%（12 495/45 108） and 38.60%（17 412/45 108）, respectively. There was statistically significant difference（P〈0.01）. （4） The emergency cesarean section rate of full-term low birth weight infants was 41.09%（468/1 139）, which was higher than that of normal birth weight infants （31.09%, 14 024/45 108）. The difference was statistically significant （P〈0.01）. （5） The rates of stillbirth, neonatal asphyxia and the mortality of full-term low birth weight infants were 2.36%（44/1 863）, 6.12%（114/1 863）, and 3.17%（59/1 863）, respectively. Those

关 键 词：婴儿 出生时低体重 剖宫产术 妊娠结局 

分 类 号：R714.7[医药卫生—妇产科学]