基于产妇和胎儿因素构建新生儿窒息风险评分系统  

The establishment of neonatal asphyxia risk score system based on maternal and fetal factors

作　　者：郭学齐[1] 兰晓红[1] 陈艳[1] Guo Xueqi

机构地区：[1]浙江省丽水市人民医院,323000

出　　处：《浙江临床医学》2020年第12期1717-1719,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨通过产妇与胎儿临床资料初步构建新生儿窒息风险评分系统,为新生儿窒息的防控提供参考。方法回顾性收集2018年9月1日至2019年10月31日间分娩的153例窒息新生儿作为病例组,选取同时期分娩的2237例非窒息新生儿作为对照组,通过Logistic回归进行影响因素分析,建立新生儿窒息的风险评分系统,ROC曲线用于评价评分系统预测效能。结果多因素Logistic回归分析显示,产妇年龄≥35岁、前置胎盘、脐带绕颈、低出生体重儿、产程异常以及胎儿宫内窘迫是发生新生儿窒息的独立相关因素。风险总分值为8分,其中产妇年龄≥35岁(1分)、前置胎盘(1分)、脐带绕颈(2分)、低出生体重儿(1分)、产程异常(1分)、胎儿宫内窘迫(2分)。模型评价显示,该评分系统ROC曲线下面积为0.788,灵敏度为66.01%,特异度为79.12%,约登指数为45.13%,分值≥4分为发生新生儿窒息高危人群。结仑该风险评分系统有助于早期监测高危产妇和胎儿,降低新生儿窒息的发生。Objective To develop a risk scoring system to predict neonatal asphyxia based on puerpera and fetus factors,and provide references for the prevention of it.Methods 153 Cases of clinical asphyxia neonatorum from September 1,2018 to October 31,2019 in Lishui people's hospital were selected as the case group,and 2237 neonatorum who did not have clinical asphyxia in the same period were selected as a control group.A risk scoring system was developed on the results of the multivariate Logistic model,effect of model prediction was assessed with ROC curve.Results Logistic regression analysis showed that puerpera age≥35,placenta previa,umbilical cord around neck,low birth weight infant,abnormal labor,and fetal distress were independent correlation factors of neonatal asphyxia.A 8-point risk score was developed,including puerpera age≥35(1 point),placenta previa(1 point),umbilical cord around neck(2 point),low birth weight infant(1 point),abnormal labor(1 point),and fetal distress(2 points).The area under ROC curve(AUC)of the scoring system in derivation group was 0.788,the sensitivity and specificity were 66.01%and 79.12%respectively.Patients with the risk score≥4 points were the high-risk population of neonatal asphyxia.Conclusion The risk scoring system is helpful for early monitoring high-risk population,and reducing the occurrence of neonatal asphyxia.

关 键 词：新生儿窒息 危险因素 风险评分 

分 类 号：R71[医药卫生—妇产科学]