即刻剖宫产新生儿入重症监护病房的危险因素  

Risk factors for newborns entering into the intensive care unit immediately after cesarean section

作　　者：朱思颖 魏大源 张丹 陈本祯 张海萍 高岩 张健 ZHU Siying;WEI Dayuan;ZHANG Dan;CHEN Benzhen;ZHANG Haiping;GAO Yan;ZHANG Jian(Anesthesia Operation Center,Sichuan Provincial Maternity and Child Health Care Hospital,Chengdu 610041,China)

机构地区：[1]四川省妇幼保健院成都医学院附属妇女儿童医院麻醉手术中心,610041 [2]四川省妇幼保健院成都医学院附属妇女儿童医院妇女保健科,610041 [3]四川省妇幼保健院成都医学院附属妇女儿童医院产科,610041 [4]成都医学院研究生院

出　　处：《临床麻醉学杂志》2022年第8期829-832,共4页Journal of Clinical Anesthesiology

基　　金：四川省省卫计委课题(17PJ239)。

摘　　要：目的探讨自决定手术到新生儿剖出时间(DDI)<15 min的即刻剖宫产新生儿入新生儿重症监护病房(NICU)的危险因素。方法选择2019年3月至2021年3月行即刻剖宫产的产妇130例,ASAⅠ—Ⅲ级。根据新生儿结局分为两组:新生儿入NICU(N组)和新生儿未入NICU(C组)。采用单因素和多因素Logistic回归分析DDI<15 min的即刻剖宫产新生儿入NICU的危险因素,并采用受试者工作特征曲线(ROC)评价预测效能。结果术后转入NICU的新生儿28例(21.5%)。多因素Logistic回归分析显示:产妇合并症增加(OR=1.59,95%CI 1.04~2.43,P=0.03)、新生儿早产(OR=37.38,95%CI 10.26~139.05,P<0.01)、新生儿出生后1 min Apgar评分<8分(OR=11.90,95%CI 2.81~50.47,P<0.01)是DDI<15 min的即刻剖宫产新生儿进入NICU的独立危险因素。根据多因素Logistic回归模型得出ROC曲线,曲线下面积(AUC)为0.84(95%CI 0.77~0.97),敏感性82.1%,特异性93.1%。结论在DDI<15 min的即刻剖宫产中,产妇合并症数量增加,新生儿早产、出生后1 min Apgar评分<8分是新生儿进入NICU的危险因素。Objective To explore the risk factors for newborns entering the neonatal intensive care unit(NICU)with decision to delivery interval(DDI)<15 minutes of emergency cesarean section.Methods A total of 130 pregnant women who underwent emergency cesarean section from March 2019 to March 2021 were selected,ASA physical statusⅠ-Ⅲ.According to the outcome of newborns,they were divided into two groups:entering into NICU(group N)and not entering into NICU(group C).The risk factors were analyzed using univariate and multivariate Logistic regression analysis methods,and receiver operating characteristic curve(ROC)was used to evaluate the effect of prediction.Results Twenty-eight(21.5%)newborns were transferred to NICU after operation.Multivariate Logistic regression analysis showed that increased maternal complications(OR=1.59,95%CI 1.04-2.43,P=0.03),preterm birth(OR=37.38,95%CI 10.26-139.05,P<0.01),Apgar score<8 at 1 minute after birth(OR=11.90,95%CI 2.81-50.47,P<0.01),were the independent risk factors for newborns entering NICU.The ROC curve was obtained according to the Logistic regression model,and the area under the curve(AUC)was 0.84(95%CI 0.77-0.97).The sensitivity was 82.1%,and the specificity was 93.1%.Conclusion In the immediate cesarean section with DDI<15 minutes,increased maternal complications,premature delivery and Apgar score<8 at 1 minute after birth of newborns are the risk factors for newborns entering NICU.

关 键 词：即刻剖宫产 新生儿结局 危险因素 

分 类 号：R719.8[医药卫生—妇产科学]