Short-term Clinical Outcomes Of Neonates Of Secundiparous Mothers:a Single-center Cohort Study

Objective:To analysize the maternal age distribution characteristics in the region after two child policy going,comparing the influence of changes in the rate of cesarean section.To investigate the short-term clinical outcomes of neonates of secundiparous mothers,and to provide a reference for the clinical work in the perinatal period after the change in birth policy.Methods:This experiment is a prospective observational study,the research object is 4091 cases of neonatal deliveried in Maternal and Child Health Hospital of Yongkang city from June 2015 to April 2016,including 2141 cases of boy infants and 1950 cases of girl infants.A cohort study was performed for the parturients and their neonates.They were divided into primiparous group including 2023casesand secundiparous group including 2068 cases.Recorded all informations of mothers from these cases in the perinatal period:including pregnancy time,delivery time,delivery methods,age,placenta previa,premature rupture of membranes,placental abruption,gestational diabetes,gestational hypertension,gestational thyroid disease,etc.Recorded informations of newborn:gestational age,birth weight,asphyxia,turn to neonatal wards,neonatal respiratory distress syndrome(NRDS),Transient tachypnea of newborn(TTN),pneumonia,small for gestational age(SGA),sepsis,pathological jaundice,hypoglycemia,hypoxic ischemic encephalopathy(HIE),and pneumothorax.Given mechanical ventilation and oxygen therapy,antibiotics,percutaneonsly/peripherally inserted central catheter/umbilical venous catheters(PICC/UVC),transfusion treatment,etc.The short-term clinical outcomes of neonates were compared between the two groups.Using SPSS 19.0 statistical software,to compare difference of maternal age distribution ratio,the rate of born vaginally and cesarean section,and the proportion of different gestational age between two groups.To analysize gestational age characteristics in cesarean delivery.Analysis and the differences of maternal obstetric complications and neonatal outcome.Results:The primiparous group average birth weight of 3160±490g,and secundiparity group average birth weight of 3280±450g,the birth weight in primiparous group was lower than secundiparity group,the difference was statistically significant(P<0.01).There were 405 infants turn into the neonatal ward with illness factors after birth.The difference of maternal age distribution in two groups was statistically significant(P<0.05).In the primiparousgroup,most mothers(56.90%)were aged less than 25 years,and 23.73%were aged 26-34 years,19.38%were aged above 35 years.one set of maternal age is given priority to with 25 years of age(56.90%)or less,from 26 to 34 years accounted for 23.73%,35 years old or above accounted for 19.38%.In the secundiparous group,most mothers(57.16%)were aged 26-34 years,26.35%were agedless than 25 years and 16.49%were aged above 35 years.Secundiparity group focused on maternal age 26 to 34 years old(57.16%),25,accounting for 26.35%or less,for more than 35 years of age accounted for 16.49%.The difference of born way has statistics significance in two groups(P<0.05).Compared with the primiparous group,the secundiparous group had significantly higher cesarean section rate(42.55%vs 25.06%),and the secundiparity group proportion of 37?38 weeks gestational age was obviously higher than that of one group(P<0.05),but both groups of gestational age is given priority to with 39 weeks or more.The gestational age 39 weeks or more in cesarean section was born accounted for 15.22%(308/2023)in primiparous group and 18.13%(375/2 068)in Secundiparity group.Thesecundiparity group had lower incidence of premature rupture of membranes mother thantheprimiparousone,difference was statistically significant(P<0.05).Other complications of mothers' there was no statistically significant difference(P>0.05).In primiparous group,266 babies(13.16%)tranfered neonatal ward born,of which 34.96%of cesarean section birth;inSecundiparity group,139 cases(6.82%)tranfered neonatal ward,including 51.08%cesarean section birth.The percentages of NRDS(8.6%vs 3.4%)and TTN(7.2%vs 2.6%)in hospitalized neonates from the secundiparous mothers were higher than the primiparous group.(P<0.05).Neonatal pneumonia,SGA,pathological jaundice,hypoglycemia,sepsis,neonatal asphyxia,the incidence of HIE,gas chest were no statistically significant difference(P>0.05),which as seem as the treatment comparison.Conclusions:1.Secundiparity maternal age distribution obviously backward,but elderly parturient women are not the major population of secundiparous parturients,therefore don't worry about mother-effects on neonatal outcome may cause.2.The neonates of secundiparous mothers have a higher rate of births by cesarean section,which might be associated with increased percentages of NRDS and TTN in hospitalized neonates from the secundiparous mothers.Therefore,it has important influence to advocate the primiparous vaginally born and reduce cesarean section rate.