Analysis Of The Related Factors Of Premature Infants And Brain Injury

ObjectiveIn order to provide the basis for preventing the occurrence of premature infants and brain injury and offer early intervention,to understand the perinatal factors of preterm infants and the incidence of complications during hospitalization by analyzing retrospectively the clinical data of hospitalized premature infants in the neonates department of Anhui provincial children’s Hospital.And to discuss the incidence of brain injury in preterm infants and related risk factors.MethodsThe clinical data of preterm infants in the neonates department from January 1,2016 to December 31,2016 was collected.The perinatal factors of preterm infants including the gestational age,birth weight and the complications were retrospectively analyzed.The relationship in different gestational age,birth weight and related diseases also were analyzed.According to the result of cranial ultrasound examination,the subjects were divided into pveriventricular intraventricular hemorrhage(PVH-IVH)group and non-PVH-IVH group;PVL group and non-PVL group.Prenatal data including pregnant mother age,intrauterine infection,pregnancy complications and so on;clinical data at birth: sex,birth age,birth weight and so on,The data after birth: respiratory distress syndrome(RDS),apnea,pulmonary hemorrhage and so on.Then univariate analysis and further multivariate Logistic regression was used to analyze the risk factors for brain damage in preterm infants.Results1.A total of 714 preterm infants were collected,including 401 male and 313 female,Average GA was(33.7±2.5)(26 ~36.8)W,average BW was(2139.2 ±595.4)(650~4000)g.The incidence of perinatal factors in perinatal period were pregnancy induced hypertension syndrome(11.3%),premature rupture of membranes(11.1%)and multiple pregnancy(10.2%).Preterm infants were prone to various complications,including respiratory diseases(82.5%),nervous system diseases(59.4%),and hematological diseases(49.3%)and so on.The incidence of neonatal pneumonia(64.1%)was highest in the respiratory system;the incidence of PVH-IVH(52.7%)was highest in the nervous system;the incidence of anemia(30%)in the hematological system was highest;The result showed that the lower the gestational age and the birth weight,the incidence of pneumonia,RDS,necrotizing enterocolitis of the newborn(NEC),neonatal hyperbilirubinemia anaemia and hypoglycemia were higher,the difference was statistically significant(P < 0.05).But there was no statistically significant difference between premature birth asphyxia and gestational age and birth weight(P > 0.05).2.The incidence of PVH-IVH(376 cases)was 52.7%,of which 35 cases of grade I(9.3%),295 cases of grade II(78.5%),42 cases of grade Ⅲ(11.2%),4 cases with grade IV(1.0%).The incidence of PVL(174 cases)was 24.4%,of which 146 cases of grade I(83.9%),16 cases of grade II(9.2%),9 cases of grade(5.2%),3 cases with grade IV Ⅲ(1.7%).The univariate analysis showed that gestational age,birth weight in the PVH-IVH group were lower than those in non-PVH-IVH group,in the PVH-IVH group,the incidence of intrauterine infection,birth asphyxia,apnea,pulmonary hemorrhage,RDS,respiratory failure,mechanical ventilation,congenital heart disease,anemia,hypoglycemia,metabolic acidosis were higher than non-PVH-IVH group,the differences was statistically significant(P < 0.05);the gestational age,birth weight in the PVL group were lower than those in non-PVL group,in the PVL group,the incidence of cesarean section,intrauterine infection,birth asphyxia,apnea,RDS,respiratory failure,mechanical ventilation,anemia,hypoglycemia,metabolic acidosis were higher than the non-PVL group,the differences was statistically significant(P < 0.05).The multivariate Logistic regression analysis showed that gestational age,birth weight,birth asphyxia,RDS,respiratory failure,congenital heart disease and metabolic acidosis were independent risk factors of preterm PVH-IVH(P < 0.05);the gestational age,RDS,hypoglycemia,anemia were independent risk factor for preterm PVL(P < 0.05).ConclusionThe incidence of perinatal factors in preterm birth was pregnancy induced hypertension syndrome,premature rupture of membranes,multiple pregnancy and so on.The most common neonatal diseases in preterm infants were neonatal pneumonia,PVH-IVH,anemia and so on.The main risk factors of PVH-IVH in premature infants were low birth weight and low birth weight,asphyxia,RDS,respiratory failure,congenital heart disease and metabolic acidosis.The main risk factors of PVL in premature infants were low gestational age,RDS,hypoglycemia and anemia.Therefore,the perinatal management should be strengthened to avoid premature birth and reduce the occurrence of postpartum complications,which can reduce the occurrence of brain injury in preterm infants.