早发型新生儿败血症发生的围生期危险因素调查分析及预测模型建立  

Investigation and analysis of perinatal risk factors for early onset neonatal sepsis and establishment of prediction model

作　　者：丁杨[1] 方广东[1] 江敏[2] DING Yang;FANG Guang-dong;JIANG Min(Department of Child Health,Wuxi Maternal and Child Health Hospital,Wuxi 214002,China;Department of Neonatology,Wuxi Maternal and Child Health Hospital,Wuxi 214002,China)

机构地区：[1]无锡市妇幼保健院儿童保健科,江苏无锡214002 [2]无锡市妇幼保健院新生儿科,江苏无锡214002

出　　处：《哈尔滨医科大学学报》2024年第1期53-58,共6页Journal of Harbin Medical University

基　　金：江苏省卫生健康委医学科研面上项目(M20200066);江苏省卫生健康委科研项目(Z2020042)。

摘　　要：目的 探究早发型新生儿败血症发生的围生期危险因素,并建立预测模型。方法 选取2020年6月~2022年2月在我院分娩出生的早发型新生儿败血症患儿66例纳入研究组,另选50例在我院新生儿科住院的无败血症诊断新生儿纳入对照组,收集两组患儿的临床资料,探究影响早发型新生儿败血症发生的因素,并建立相应的预测模型。结果 发生早发型新生儿败血症的母体与无败血症诊断新生儿母体比较,妊娠年龄偏大,存在流产史、胎盘异常、羊水量异常、胎膜早破、产前发热情况的比例更高(P<0.05)。患早发型新生儿败血症的新生儿早产儿、低体重及极低体重、湿肺占比较高(P<0.05)。母体妊娠年龄高于35岁、产前发热,新生儿为早产儿、出生低体重及极低体重、湿肺均会影响早发型新生儿败血症的发生(P<0.05)。经预测模型诊断,116例新生儿中有57例预测为正常,59例预测为早发型新生儿败血症。以临床诊断为金标准,预测模型对新生儿出现早发型新生儿败血症预测的准确率为87.07%,敏感度为83.33%,特异度为92.00%,阳性预测值为93.22%,阴性预测值为80.70%。结论 母体妊娠年龄高于35岁、产前发热,新生儿为早产儿、出生低体重及极低体重、湿肺会影响早发型新生儿败血症的发生,应予以密切关注。本研究建立的预测模型对早发型新生儿败血症具有一定预测价值。Objective To explore the perinatal risk factors of early onset neonatal sepsis and establish a predictive model.Methods A total of 66 children with early-onset neonatal sepsis who were born in our hospital from June 2020 to February 2022 were selected to be included in the study group,and 50 newborns without sepsis diagnosis hospitalized in the neonatology department of our hospital were selected to be included in the control group.Clinical data of the two groups of children were collected to explore the factors affecting the occurrence of early-onset neonatal sepsis,and the corresponding prediction model was established.ResulstsCompared with mothers without a diagnosis of sepsis,the mothers with early-onset neonatal sepsis had older gestation age,more abortion history,abnormal placenta,abnormal amniotic fluid volume,premature rupture of membranes,and prenatal fever(P<0.05).The proportion of premature infants,low body weight and very low body weight,wet lung with early onset neonatal sepsis was higher(P<0.05).Maternal gestational age over 35 years old,prenatal fever,premature birth,low birth weight and very low birth weight all affected the occurrence of early-onset neonatal sepsis(P<0.05).According to the prediction model,57 of the 116 neonates were diagnosed as normal and 59 were diagnosed as early-onset neonatal sepsis.With clinical diagnosis as the gold standard,the accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of early onset neonatal sepsis were 87.07%,83.33%,92.00%,93.22%,and 80.70%respectively.Conclusion Maternal gestational age over 35 years old,prenatal fever,premature birth,low birth weight and very low birth weight may affect the occurrence of early-onset neonatal sepsis,and should be paid close attention to.The predictive model established in this study has certain diagnostic value and can assist in the diagnosis of early-onset neonatal sepsis.

关 键 词：早发型新生儿败血症 危险因素 预测模型 围生期 

分 类 号：R722.13[医药卫生—儿科]