Comparison Of Preterm Infant's Clinical Featues Caused By Different Reasons

Premature labor, a common pregnancy complication, has a higher morbility and mortality, and is also a main reason of disability. It is reported that 75% of neonatal death in the perinatal period is associated with preterm delivery, and of the survivors, more than half will exhibit mental retardation or permanent neurological deficits. Latest research indicated that preterm delivery is not only an important reason of neonatal death, but also associate closly with such adult diseases as non-insulin dependent diabetes, coronary heart disease or hypertension. Preterm delivery and premature baby have been the key research object in perinatology and pediatrics. The main causes of preterm delivery are premature rupture of fetal membranes, placental abruption, pregnancy induced hypertension syndrome, double or multiple pregnancies, history of abortive and inducing outcome. Report is rare as for the clinical traits and the differences among neonates caused by thus different reasons.ObjectiveThe objective of this study is to compare the clinical traits of premature babies caused by premature rupture of membranes, pregnancy induced hypertension syndrome and placental abruption, for preventing and curing of premature diseases and improving the newborn living quality.Materials and Methods1 Source of materialsResearch objective:The clinical features of 343 preterm babies admitted to NICU from December 1st,2008 to September 30th,2009 were analyzed. Among which,149 cases were linked with preterm premature rupture of membranes(PROM) (Group A),126 cases were linked with preterm labor with pregnancy induced hypertensive syndrome(PIH) (Group B)and 68 cases were associated with placental abruption (Group C).2 Collecting and analyzing of the materials(1) Obstetrical data:including mother's common reference (age, birth number, history of abortive and inducing outcome, etal), Occurrence of PROM and infection, the degree of placenta abruption, the degree and the duration of PIH,antenatal drug (corticosteroids and antibiotics)administer.(2) Neonatal delivery status:Birth weight, delivery mode, Apgar score, amniotic fluid, umbilical cord, placenta status, history of neonatal asphyxia.(3) Data of neonate:Vital signs and system function of the neonate, observing and recording of infection(for example:pneumonia, septicemia), breath state, cardiac enzymes, coagulation function test, blood sugar, electrolyte, ALP+CRP and other laboratory check in the first 72 hours, do germiculture when suspecting infection, use X-ray to check pulmonary diseases and so on.3 The judgment of criterion for outcomeAccording to the different states of illness, prognosis is divided into three forms, recovery, improvement, death.(1) Criterion of recovery:the vital signs keep stable, the complications during acute period have recovered, the body weight is more than 2kg, the milk ingestion can meet the standard of physiological needs.(2) Criterion of improvement:the vital signs keep stable relatively, fatal complications is under control, the infants body weight and milk ingestion have not meet the ideal standard.(3) Criterion of death:premature infants is dead even with active treatment.4 Statistics analysisData was represented by x±s and percent, the data were calculated by SPSS 12.0 statistical analysis software.One-way ANOVA,Chi-Square Tests and q Tests was used according to the specific purpose.a=0.05 is the significance level. Results(1) No significant difference were found among the three groups with regard to gestational age, twin labor ratio and mortality rate(P＞0.05).Weight of premature infants in the PIH group is lower than the other two groups. Premature infants in the PIH group and the placental abruption group have high incidence of asphyxia than the PROM group.(2) There exist differencs in WBC count and CRP positive rate(P<0.05) among the three groups (P＜0.05). The WBC count in the PROM group has comparable significant difference with the PIH group(P<0.05).CRP positive rate in the PROM group has comparable significant difference with the other groups(P<0.01).(3) The PROM group has higher pneumonia rate, shortest hospital stay (P＜0.05),compared with the other groups.It seemed that the RDS incidence rate of the PROM group was lower compared with the other groups, but no significant difference were found (P＞0.05)(4) The incidence rate of abnormal cruor in the placental abruption group was significantly higher than the other two groups (P＜0.05)(5) No significant difference were found among the three groups with regard to abnormal rate of sodium ion, potassium ion and blood sugar (P＞0.05)Conclusions(1) There exist differencs in the birth weight, asphyxia ratio, infection and abnormal cruor among the premature babies related with PROM,PIH and the placental abruption.(2) The clinical features were different in the premature babies with different reasons and management should be different accordingly. For the preterm infants related to PROM, it is important to put emphasis on the management of infection.For the preterm infants resulting from PIH and placental abruption, more attention should be paid to nutrition support, asphyxia and the inspection of cruor function respectively.