O型血伴血清IgG抗A(B)抗体效价轻度异常产妇致新生儿溶血的危险因素分析  

Analysis of risk factors for neonatal hemolysis in women with low serum IgG anti-A(B)antibody valence of type O blood

作　　者：张倩 晋艳婷 ZHANG Qian;JIN Yanting(Blood Transfusion Department of Hainan Women and Children’s Medical Center,Haikou,Hainan 570216,China)

机构地区：[1]海南省妇女儿童医学中心输血科,海南海口570216

出　　处：《中国优生与遗传杂志》2023年第6期1213-1217,共5页Chinese Journal of Birth Health & Heredity

摘　　要：目的探索O型血伴血清免疫球蛋白G(IgG)抗A(B)抗体效价轻度异常产妇致新生儿溶血(HDN)的危险因素。方法回顾性分析2018年3月至2022年8月于海南省妇女儿童医学中心治疗的200例O型血伴IgG抗A(B)抗体效价轻度异常产妇作为研究对象,根据是否出现新生儿溶血分为2组:病例组和对照组,其中病例组52例,对照组148例。收集并记录每个产妇的年龄、孕次、孕周、分娩方式,以及新生儿性别、血型、身长、体质量、Apgar评分等临床资料。采用多因素Logistic回归筛选危险因素,进行相关性分析和敏感性分析。结果单因素分析表明,新生儿身长、新生儿体质量、新生儿Apgar评分、产妇年龄、产妇孕次、孕周组间比较,差异有统计学意义(P<0.05)。将单因素分析中P<0.05的临床变量纳入多因素Logistic回归,筛选出的危险因素为新生儿身长、新生儿体质量、新生儿Apgar评分、产妇年龄、孕周(P<0.05)。最终的模型为Logit(P)=22.911-0.067×新生儿身长-0.890×新生儿体质量-0.584×新生儿Apgar评分+0.176×产妇年龄-0.453×孕周。模型显示:新生儿身长每增加1 cm,患新生儿溶血的风险下降6.5%[OR值及95%CI:0.935(0.900~0.971)];新生儿体质量每增加1kg,患病风险下降58.9%[OR值及95%CI:0.411(0.184~0.916)];新生儿Apgar评分每增加1分,患病风险下降44.2%[OR值及95%CI:0.558(0.406~0.766)];产妇年龄每增加1岁,患病风险上升19.2%[OR值及95%CI:1.192(1.067~1.331)];孕周每增加1周,患病风险下降36.4%[OR值及95%CI:0.636(0.517-0.781)]。新生儿身长与新生儿体质量呈正相关(r=0.149,P=0.027),新生儿身长与产妇年龄呈负相关(r=-0.180,P=0.007),新生儿体质量与新生儿Apgar评分呈正相关(r=0.136,P=0.044),新生儿体质量与孕周呈正相关(r=0.147,P=0.028)。敏感性分析表明,排除少数民族产妇后,多因素分析得到的危险因素与之前相同,说明上述多因素分析结果具有稳健性。结论新生儿身长、Objective To explore the risk factors of neonatal hemolysis in women with low serum IgG anti-A(B)antibody valence of type O blood.Methods From March 2018 to August 2022,200 cases of O blood with low-valent IgG anti-A(B)antibody treated in Hainan Women and Children’s Medical Center were retrospectively analyzed as the research objects.According to whether neonatal hemolysis occurred,they were divided into two groups:case group(n=52)and control group(n=148).Clinical data such as age,gestational age,gestational age,mode of delivery,gender,blood type,length,weight,Apgar score and other clinical data of each puerpera were collected and recorded for each puerpera.Multivariate logistic regression was used to screen for risk factors,and correlation analysis and sensitivity analysis were performed.Results Univariate analysis showed that there were significant differences in neonatal length,neonatal weight,neonatal Apgar score,maternal age,maternal gestational times and gestational weeks between the two groups(P<0.05).The clinical variables with P<0.05 in univariate analysis were included in multivariate Logistic regression,and the selected risk factors were neonatal length,neonatal weight,neonatal Apgar score,maternal age and gestational age(P<0.05).The final model was Logit(P)=22.911-0.067×neonatal length-0.890×neonatal weight-0.584×neonatal Apgar score+0.176×maternal age-0.453×gestational week.The model showed that the risk of neonatal hemolysis decreased by 6.5%for each 1 cm increase in neonatal length[OR and 95%CI:0.935(0.900-0.971)].For every 1 kg increase in neonatal body weight,the risk decreased by 58.9%[OR and 95%CI:0.411(0.184-0.916)].For every 1 point increase in Apgar score,the risk decreased by 44.2%[OR and 95%CI:0.558(0.406-0.766)].For every 1 year increase in maternal age,the risk increased by 19.2%[OR and 95%CI:1.192(1.067-1.331)].For each additional week of gestational age,the risk decreased by 36.4%[OR and 95%CI:0.636(0.517-0.781)].Neonatal body length was positively correlated with neonatal body

关 键 词：O型血 IgG抗A(B)抗体 新生儿溶血 多因素Logistic回归 敏感性分析 

分 类 号：R722.18[医药卫生—儿科]