健康足月新生儿视网膜出血发生情况及危险因素分析  

Analysis about the incidence and risk factors of retinal hemorrhage in healthy full-term neonatal

作　　者：巴依尔才次克[1] 郑秋仙 李明霞[1] Bayiercaicike;ZHENG Qiu-xian;LI Ming-xia(Department of Neonatal,The First Affiliated Hospital of Xinjiang Medical University,Urumqi,830011,China)

机构地区：[1]新疆医科大学第一附属医院新生儿科,乌鲁木齐830011

出　　处：《新疆医学》2020年第11期1150-1154,共5页Xinjiang Medical Journal

摘　　要：目的研究健康足月新生儿视网膜出血(Retinal hemorrhage,RH)发生情况、分度及危险因素,为早期预防和干预提供理论依据。方法收集2019年1月-2019年8月某医院分娩出生的符合纳入标准的1335名健康足月新生儿,于生后1-5天内行Ret Cam III眼底筛查,根据有无视网膜出血分为视网膜出血组和正常对照组,新生儿RH组按照Egge分级标准分为I、II、III级,无RH组作为正常对照组。计算新生儿RH发生情况及不同程度分级的发生占比。单因素Logistic回归对新生儿RH有关的危险因素进行筛选,将P<0.10的影响因素进一步采用有序多分类Logistic回归分析。结果1335例健康足月新生儿中发生RH 135例(10.11%),其中I度RH 61例(45.18%),II度RH 35例(28.89%),III度RH 39例(25.92%),左右眼出血程度差异无统计学意义。本研究发现:出生体重、日龄、分娩方式、产程延长、产前助产、产妇BMI、GDM、初产、胎儿宫内窘迫在RH组与正常组之间差异有统计学意义(P<0.05)。将单因素Logistic回归分析中对P<0.1的因素进行有序多分类Logistic回归分析显示:脐带绕颈、胎儿宫内窘迫、自然分娩对新生儿RH分级严重程度的影响差异有统计学意义。结论本文探讨的新生儿RH发生率为10.11%,III度RH 35例(占25.92%),占全部视网膜出血组的接近三分之一,左右眼RH分级程度无差别。出生体重、日龄、分娩方式、产程延长、产前助产、产妇BMI、GDM、初产、胎儿宫内窘迫是新生儿RH发生的危险因素。脐带绕颈、胎儿宫内窘迫、自然分娩是RH分级程度加重的危险因素。Objective To investigate the occurrence and its related factors of retinal hemorrhage in healthy full-term infants.Methods A case-control study was carried out in 1,335 healthy full-term newborns born from January 2018 to August 2018.Ret Cam III fundus screening was performed within 1-5 days of newborns,and the results were blinded and independently read by two experienced ophthalmologists.According to the presence or absence of retinal hemorrhage,the retinal hemorrhage group were divided into group I,II,III according to the Egge classification criteria,and the cases without retinal hemorrhage were divided into control group.The incidence rate of neonatal retinal hemorrhage was calculated.The risk factors related to neonatal retinal hemorrhage were screened by single factor Logistic regression.The influencing factors of P<0.10 were further analyzed by ordered multi-class logistic regression analysis.Results Among1335 healthy full-term newborns,135 cases(10.11%)had RH,among which 61 cases(45.18%)were grade I of RH,35 cases(28.89%)were grade II,and 39 cases(25.92%)were grade III in RH.There was no statistically significant difference in the degree of haemorrhages between the left and right eyes.The results showed that birth Weight,mode of delivery,extended labor,prenatal midwifery,maternal BMI,GDM,fetal distress,first delivery were statistically different between RH group and normal group.There were significant differences(P<0.05).Univariate logistic regression analysis showed that there were significant differences in the effects of.BW,umbilical cord around the neck,fetal distress,mode of delivery on the grade of neonatal RH(P<0.05).Ordered multi-class logistic regression analysis of factors with P<0.1 in one-way logistic regression analysis showed that there were statistical differences in the effects of umbilical cord around the neck,intrauterine distress,and natural delivery on the severity of neonatal RH classification.Conclusions The incidence of neonatal RH in this study was 10.11%,and 35 cases of grade RH(2

关 键 词：足月新生儿 眼底检查 视网膜出血 危险因素 严重程度 

分 类 号：R722.1[医药卫生—儿科]