The Risk Factors Of Brain Injury In Premature Infants

Objective:With the increased birthrate and survival of premature infants,the incidence of brain injury in premature infants is also increasing.At present,the lack of effective treatment for brain injure,how to prevent the occurrence of brain injury in premature infants has becameimportant content.Although there are many studies on the factors of brain injury in premature infants/neonates,there are some shortcomings such as small sample size and imperfect statistical analysis.This study analyzed 31 factors by univariate and multivariate,include obstetric factors,fetal factors,neonatal factors and hemoglobin,hematocrit and thyroxine levelsect.It comprehensively analyzed the birthrate of premature infants,the incidence of brain injury of premature infants in this hospitaland related risk factors.The aim to prevent the high-risk infants who may have brain injury in advance and avoid the occurrence of brain injury as far as possible.Methods:This study analyzed 2958 cases of neonates born in obstetrical department of The Second Affliated Hospital of Dalian Medical University from September 2016 to January2019,including 204 cases of premature infants.There were 66 cases in the brain injury group of premature infants,30 boys and 36 girls,theratio was 1:1.2.Brain injury in preterm infants were diagnosedaccording to the 2012 edition of Expert Consensus on Diagnosis and Prevention of Brain Injury in Premature Infants.There were 138 cases in control group(non-brain injury group)without any clinical symptoms,signs or imaging changes related to brain injury.A total of 31 factors including general data,obstetric data,fetal factors and neonatal factors were collected as research variables.The data collected were analyzed by SPSS23.0 software,and the counting data were tested by?~2 test,in which the data were expressed as percentage[n(%)].The measurement data conform to normal distribution by t-test and were expressed by mean±standard deviation(X±SD).Multivariate Logistic regression analysis was used to identify the risk factors of brain injury in premature infants.P<0.05 had statistical significance,OR greater than 1was the risk factor.Results:1.The birthrate of premature infants was 6.89%,and the incidence of brain injury was 32.35%.The average gestational age and birth weight of premature infants in brain injury group were 232.09±14.79 days and 2031.44±522.82g,which were smaller than those in non-brain injury group,and the difference between the two groups was statistically significant.2.The analysis results of ?~2 univariate test:There were significant differences in the frequency of hypertensiondisorder in pregnancy,gestational diabetes mellitus,pregnancy infection,preterm premature rupture of membranes>12h,umbilical cord abnormality,multiple pregnancy,asphyxia of newborn,neonatal DIC,neonatal infectious diseases,pulmonary respiratory failure,mechanical ventilation,hemoglobin with control group.Other risk factors:the differences of delivery mode,pregnancy with thyroid disease,polyhydramnios or oligohydramnios,other diseases during pregnancy,placenta abnormality,amniotic fluid pollution,fetal distress,congenital heart disease between brain injury group and non-brain injury group did not have statistical significance.3.Laboratory results t test:The mean of HGB and Hct in premature infants with brain injury was higher than that in the control group,and the mean of FT4 was lower than that in the control group.The difference between the two groups had statistically significant.4.The multivariate Logistic regression analysis:There were 17 variables with statistical differences between the two groups.Neonatal asphyxia,neonatal DIC,neonatal postnatal infection,gestational age less than 34 weeks,gestational diabetes mellitus, gestational infection and mechanical ventilation were risk factors for brain injury in premature infants,which were 8.385 times,22.005 times,4.074 times,2.561 times,3.102 times,4.401 times and 6.979 times in non-corresponding premature infants.Hemoglobin concentration is also a risk factor for brain damage in premature infants.Conclusion:1.Gestational age less than 34 weeks,neonatal asphyxia,neonatal DIC,postnatal infectious diseases,gestational diabetes mellitus,gestational infection,mechanical ventilation and high hemoglobin concentration are risks to cause the brain injury Premature Infants.2.Neonatal DIC has the greatest impact on brain injury in premature infants..