Premature Epidemiological Investigetion And Prognosis Of Premature Infants

Objective:To explore the e risk factors of premature delivery,in order to predict premature delivery or to screening high-risk group of pregnant women, which to provide a basis to effectively improve the pregnancy outcome and newborn prognosis.Method:1.Retrospective analysis clinical data of 807 cases of preterm pregnant women and 900 cases of neonates and a random sample of 590 cases of full term pregnant women and 590 cases of neonates, both of them are due to give birth in Zhongda hospital during August 1,2006 to December 31,2014. Analyze and compare the related factors of preterm labor. Analyze clinical data of 221 cases of neonates,which give birth in our hospital during January 1,2013 to December 31,2014. Compare the effects of gestational age and birth weight in premature infants.2.Statistical methods:Use SPSS 19.0 software to analyze the data. Measurement data use t test, performed by mean± standard deviation. Count data use x2 test. If four tables from the theory of number is less than 1, or after x2 test, P close to the test level a, using Fisher’s exact to calculate. Multi group comparison use Kruskal-Wallis method. P<0.05 the difference was statistically significant.Results:1.Analysis of clinical data showed that:① the average incidence rate of premature delivery was 6.44%. The incidence of preterm labor is 5.52%,6.57%,7.05%,6.39%,6.47%,7.24%, 8.97%,5.29% from 2007 to 2012.②The incidence of age, not white-collar occupations, history of premature delivery, premature rupture of membranes, placental abruption, pregnancy induced hypertension, placenta previa, intrahepatic cholestasis of pregnancy, GDM, fetal distress,multiple pregnancies, birth weight,1 minute Apgar score,5 minute Apgar score has statistical significance between the preterm pregnant women and full-term pregnant women.③White blood cell count, percentage of neutrophils, lymphocytes percentage has statistical significance between the preterm pregnant women and full-term pregnant women’s blood test. ④The incidence of placental abruption, fetal distress, infectious medical diseases has statistical significance between the early preterm birth in pregnant women and late preterm pregnant women. The incidence of mode of delivery, neonatal birth weight, Apgar score and neonatal jaundice, neonatal infection, RDS, HIE, neonatal mortality rate of neonatal asphyxia and neonatal apnea has statistical significance between the two groups,⑤when the CRP levels of mother blood take 10.9 mg/L for the cutoff value, there was no significant difference between the two groups of early neonatal prognosis. ⑥In preterm pregnant women, the maternal serum CRP level between has statistical signifycance between the group of chorioamnionitis and no- chorioamnionitis.But early neonatal prognosis has no statistical signifycance.2. premature mortality rate and incidence of premature complications were inverse correlated with gestational age.The incidence of hyaline membrane disease, asphyxia, apnea were 40%, 40% and 20% when gestational age< 30 weeks, compare to 0.6%,4.5% in the gestational age > 34 weeks,and there was no case of apnea in premature infants of gestational age> 34 weeks.3. The incidence of hyaline membrane disease, asphyxia, apnea and premature mortality rate decreased significantly in the birth weight more than 2000g of preterm infants,.Conclusions:The study shows that:1. In recent years, the incidence of preterm birth has been rising.2. The preterm birth is the result of many factors,such as age, not white-collar occupations, history of preterm premature, rupture of membranes, placental abruption, pregnancy induced hypertension, placenta previa, ICP, GDM, fetal distress and multiple pregnancies. They are all the related risk factors of preterm delivery.3. WBC, neutrophil ratio in preterm group are higher than full-term group, which suggest that infection may play an important role in the development of premature birth..4. In preterm group, chorioamnionitis and maternal serum CRP have positive correlation.S.Gestational age and neonatal weight were the main effective factors on perinatal outcome. Bigger birth weight and/or gestational age leads to lower incidence of perinatal mortality and pulmonary hyaline membrane disease, HIE, asphyxia, apnea and so on. To prolong pregency and increase fetal weight with the precondition of matermal and fetal safety was an effective way to improve the infant’s outcome.